Serum immunosuppressive acidic protein doubling time as a prognostic factor for recurrent renal cell carcinoma after nephrectomy.
OBJECTIVE
To identify the prognostic factors in patients with recurrent renal cell carcinoma after nephrectomy, various factors were assessed, with special attention to serum immunosuppressive acidic protein (IAP) and its doubling time.


METHODS
Age, sex, stage, grade, histopathologic type, primary tumor size, site and number of metastatic organs, time to recurrence, IAP levels before nephrectomy and at the diagnosis of recurrence, and IAP doubling time just before recurrence were analyzed in 125 patients with recurrent renal cell carcinoma after nephrectomy.


RESULTS
Univariate analysis identified stage, grade, histopathologic type, primary tumor size, time to recurrence, IAP level at the diagnosis of recurrence, and IAP doubling time as significant prognostic factors. After exclusion of confounding factors, multivariate analysis showed that IAP doubling time was the most potent independent prognostic factor. Patient survival rates dichotomized according to IAP doubling time were compared at 100-day intervals from 100 to 700 days and 1000 and 2000 days. The maximal difference in survival rate was found when the cutoff level in the IAP doubling time was set at 200 days.


CONCLUSIONS
The results of our study have shown that the IAP doubling time is a potent prognostic factor in patients with recurrent renal cell carcinoma. Periodic checkups with serum IAP level monitoring are recommended to predict prognosis after recurrence.
Araki
Kazuhiro
K
Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan. wnxxx028@ybb.ne.jp
Igarashi
Tatsuo
T
Tobe
Toyofusa
T
Mizoguchi
Kenichi
K
Suzuki
Hiroyoshi
H
Furuya
Yuzo
Y
Ichikawa
Tomohiko
T
Nakatsu
Hiro-Omi
HO
Ito
Haruo
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000453:epidemiology / Q000473:pathology; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; C030193:immunosuppressive acidic protein