Prognostic significance of preoperative serum CYFRA 21-1 in patients with upper urinary tract urothelial carcinoma.
OBJECTIVE
The prognosis for upper urinary tract urothelial carcinoma is generally poorer than that for bladder cancer, and prognostic predictors with a high specificity for upper urinary tract urothelial carcinoma (UUT-UC) are needed to optimize treatment. In fact, the only preoperative predictor currently available is C-reactive protein. In the present study, we investigated the usefulness of pretreatment serum CYFRA 21-1 as a new prognostic predictor in UUT-UC.


METHODS
A total of 45 UUT-UC patients for whom serum CYFRA 21-1 was measured before treatment were included in this retrospective analysis. Patients were separated into high and low serum CYFRA 21-1 groups based on a cut-off value of 2.7 ng/mL determined from a receiver operating characteristic curve. Kaplan-Meier survival curves were calculated and the overall survival rate was statistically analyzed for the high and low pretreatment serum CYFRA 21-1 groups using the log-rank test. Multivariable analysis was carried out using the Cox proportional hazards analysis.


RESULTS
By the median follow-up period of 14.4 months, 20 patients (44.4%) had died. Of the 45 patients, 23 (51.1%) were in the high pretreatment serum CYFRA 21-1 group, and the overall survival rate of this group was significantly lower (P < 0.001). Multivariable analysis identified only distant metastasis (P < 0.001) and pretreatment serum CYFRA 21-1 (P = 0.039) as independent prognostic predictors. Distant metastasis did not significantly differ between the two groups or correlate with pretreatment serum CYFRA 21-1.


CONCLUSIONS
These findings suggest that pretreatment serum CYFRA 21-1 values could serve as a prognostic predictor of UUT-UC.
Toho University Ohashi Medical Center, Department of Urology, Tokyo, Japan. tsuyama-jua@umin.ac.jp
Taisuke
T
Suyama
Koichi
K
Nakajima
Shigeki
S
Kanbe
Norie
N
Tanaka
Hiroshi
H
Hara
Nobuhisa
N
Ishii
D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053539:Keratin-19 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D014571:Urologic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D053539:Keratin-19; C102012:antigen CYFRA21.1