title: Decoy receptor 3 is a prognostic factor in renal cell cancer.
abstract: BACKGROUND
  Decoy receptor 3 (DcR3) is a soluble protein that binds to and inactivates the death ligand CD95L. Here, we studied a possible association between DcR3 expression and prognosis in patients with renal cell carcinomas (RCCs).
  
  
  METHODS
  A tissue microarray containing RCC tumor tissue samples and corresponding normal tissue samples was generated. Decoy receptor 3 expression in tumors of 560 patients was examined by immunohistochemistry. The effect of DcR3 expression on disease-specific survival and progression-free survival was assessed using univariate analysis and multivariate Cox regression analysis. Decoy receptor 3 serum levels were determined by ELISA.
  
  
  RESULTS
  High DcR3 expression was associated with high-grade (P = .005) and high-stage (P = .048) RCCs. The incidence of distant metastasis (P = .03) and lymph node metastasis (P = .002) was significantly higher in the group with high DcR3 expression. Decoy receptor 3 expression correlated negatively with disease-specific survival (P < .001) and progression-free survival (P < .001) in univariate analyses. A multivariate Cox regression analysis retained DcR3 expression as an independent prognostic factor that outperformed the Karnofsky performance status. In patients with high-stage RCCs expressing DcR3, the 2-year survival probability was 25%, whereas in patients with DcR3-negative tumors, the survival probability was 65% (P < .001). Moreover, DcR3 serum levels were significantly higher in patients with high-stage localized disease (P = .007) and metastatic disease (P = .001).
  
  
  CONCLUSIONS
  DcR3 expression is an independent prognostic factor of RCC progression and mortality. Therefore, the assessment of DcR3 expression levels offers valuable prognostic information that could be used to select patients for adjuvant therapy studies.
authors.affiliation: Institute of Pathology, University of Heidelberg, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Macher-Goeppinger
authors.forename: Sebastian
authors.initials: S
authors.lastname: Aulmann
authors.forename: Nina
authors.initials: N
authors.lastname: Wagener
authors.forename: Benjamin
authors.initials: B
authors.lastname: Funke
authors.forename: Katrin E
authors.initials: KE
authors.lastname: Tagscherer
authors.forename: Axel
authors.initials: A
authors.lastname: Haferkamp
authors.forename: Markus
authors.initials: M
authors.lastname: Hohenfellner
authors.forename: Sunghee
authors.initials: S
authors.lastname: Kim
authors.forename: Frank
authors.initials: F
authors.lastname: Autschbach
authors.forename: Peter
authors.initials: P
authors.lastname: Schirmacher
authors.forename: Wilfried
authors.initials: W
authors.lastname: Roth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism / Q000502:physiology; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D053323:Receptors, Tumor Necrosis Factor, Member 6b / Q000235:genetics / Q000378:metabolism / Q000502:physiology*; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D053323:Receptors, Tumor Necrosis Factor, Member 6b