C-reactive protein is an informative predictor of renal cell carcinoma-specific mortality: a European study of 313 patients.
BACKGROUND
C-reactive protein (CRP) represents a promising prognostic variable in patients with sporadic renal cell carcinoma (RCC). It was hypothesized that CRP can improve the prognostic ability of standard RCC-specific mortality (RCC-SM) predictors in patients treated with nephrectomy for all stages of RCC.


METHODS
Radical nephrectomy was performed in 314 patients from 2 European centers. Life table, Kaplan-Meier, and Cox regression analyses addressed RCC-SM. Covariates included age, gender, TNM stage, tumor size, Fuhrman grade, and histologic subtype.


RESULTS
The median survival of the cohort was 19.9 years. Age ranged from 10 to 77 years. Most patients were male (69%). T-stages were distributed as follows: T1-121 (38.7%), T2-45 (14.4%), T3-140 (44.7%), T4-7 (2.2%). CRP values ranged from 1.0 to 358.0 mg/L (mean 40.9, median 11.0 mg/L). In multivariable analyses, CRP was an independent predictor of RCC-SM (P = .003). The consideration of CRP in the multivariable model increased the predictive accuracy by 3.7% (P < .001). Moreover, the model with CRP performed 2.4% and 4.6% better than the UCLA Integrated Staging System (UISS) at, respectively, 2 and 5 years.


CONCLUSIONS
CRP represents an informative predictor of RCC-SM. Its routine use could allow better risk stratification and risk-adjusted follow-up of RCC patients.
Karakiewicz
Pierre I
PI
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada. pierre.karakiewicz@umontreal.ca
Hutterer
Georg C
GC
Trinh
Quoc-Dien
QD
Jeldres
Claudio
C
Perrotte
Paul
P
Gallina
Andrea
A
Tostain
Jacques
J
Patard
Jean-Jacques
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000401:mortality*; D002648:Child; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein