title: Increased preoperative serum C-reactive protein level predicts a poor prognosis in patients with localized renal cell carcinoma.
abstract: OBJECTIVE
  To evaluate the value of the preoperative serum C-reactive protein (CRP) level in the prognosis of patients with localized renal cell carcinoma (RCC).
  
  
  METHODS
  The study comprised 101 patients who had a radical nephrectomy for localized RCC (pT1-3N0M0). An elevated CRP was defined as >0.5 mg/dL before surgery. Survival rates for each variant were calculated using the Kaplan-Meier method, with the difference between survival curves evaluated using the log-rank test. Multivariate analysis was by Cox proportional hazard model; for all analyses the difference was considered significant when P < 0.05.
  
  
  RESULTS
  The median (range) follow-up was 55 (2-187) months; 26 patients (26%) had high CRP levels, and 12 (46%) of these and three (4.0%) of the remaining 75 died from disease. The 5- and 10-year disease-specific survival rates (75% and 30%, respectively) in patients with high CRP levels were significantly worse than those in patients with normal CRP levels (both 93%, P < 0.001). In other variants, preoperative haemoglobin concentration, pathological stage, grade, histological type and microvascular tumour invasion were also related to disease-specific survival. By the Cox proportional hazards model, pathological stage and an elevated CRP were the most important prognostic factors for disease-specific survival in patients with localized RCC (P = 0.008 and 0.012, respectively).
  
  
  CONCLUSIONS
  The preoperative CRP level was associated with poor survival in patients with localized RCC.
authors.affiliation: Department of Urology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Komai
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Saito
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Sakai
authors.forename: Shinji
authors.initials: S
authors.lastname: Morimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000401:mortality / Q000601:surgery; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate
chemical_list: D002097:C-Reactive Protein