title: Prospective study of the role of inflammation in renal cancer.
abstract: BACKGROUND
  The local and systemic inflammatory responses provide prognostic information in cancer. The modified Glasgow Prognostic Score (mGPS) provides additional prognostic information than C-reactive protein (CRP) alone when assessing the systemic inflammation in cancer. The aim of this study was to determine the role of local and systemic inflammation in renal cancer.
  
  
  METHODS
  The cohort consisted of 79 patients who had undergone potential curative resection. Systemic inflammation, mGPS, was constructed by measuring preoperative CRP and albumin concentrations and the Klintrup-Makinen score was evaluated histologically for the local inflammatory response. Pathological parameters such as T stage, grade and tumour necrosis were also assessed. The local inflammatory response was assessed by examining all inflammatory cells at the tumour edge on diagnostic haematoxylin and eosin slides.
  
  
  RESULTS
  On univariate analysis, T stage (p < 0.001), grade (p = 0.044) and mGPS (p < 0.001) were significant predictors of cancer-specific survival. On multivariate analysis, mGPS (hazard ratio 8.64, 95% confidence interval 3.5-21.29, p < 0.001) was the only significant independent predictor of cancer-specific survival.
  
  
  CONCLUSIONS
  A preoperative systemic inflammatory response as measured by the mGPS is an independent predictor of poor cancer-specific survival in renal cancer in patients undergoing potential curative resection.
authors.affiliation: Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, UK.
authors.forename: T
authors.initials: T
authors.lastname: Qayyum
authors.forename: P A
authors.initials: PA
authors.lastname: McArdle
authors.forename: G W
authors.initials: GW
authors.lastname: Lamb
authors.forename: J J
authors.initials: JJ
authors.lastname: Going
authors.forename: C
authors.initials: C
authors.lastname: Orange
authors.forename: M
authors.initials: M
authors.lastname: Seywright
authors.forename: P G
authors.initials: PG
authors.lastname: Horgan
authors.forename: G
authors.initials: G
authors.lastname: Oades
authors.forename: M A
authors.initials: MA
authors.lastname: Aitchison
authors.forename: J
authors.initials: J
authors.lastname: Edwards
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D018836:Inflammation Mediators / Q000097:blood*; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000097:blood / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009336:Necrosis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009392:Nephrectomy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012606:Scotland; D012709:Serum Albumin / Q000032:analysis*; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D018836:Inflammation Mediators; D012709:Serum Albumin; D002097:C-Reactive Protein