title: Prognostic impact of pretreatment C-reactive protein for patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors.
abstract: BACKGROUND
  C-reactive protein (CRP) was an independent prognostic factor for metastatic renal cell carcinoma in the cytokine era. However, the impact of CRP on the survival of metastatic renal cell carcinoma patients treated with tyrosine kinase inhibitors has not yet been investigated. Therefore, we further evaluated the prognostic impact of CRP for patients with metastatic renal cell carcinoma treated with molecular-targeted agents of tyrosine kinase inhibitors.
  
  
  METHODS
  Fifty-two patients were treated with tyrosine kinase inhibitors for metastatic renal cell carcinoma at our institution. Overall, 31 and 21 patients were administered sunitinib and sorafenib, respectively. The prognostic value of all variables, including CRP, for overall survival was assessed using the Cox proportional hazards model.
  
  
  RESULTS
  The median baseline CRP level was 4.9 mg/l. In multivariate analysis, CRP was an independent predictor for overall survival as both continuous and categorical variable. The median overall survival times of patients with non-elevated CRP concentration (<8 mg/l) were not reached, compared with those of patients with elevated CRP concentration (8 mg/l or greater) of 15.9 months. There was a significant difference in overall survival rates between the two groups, with 1- and 3-year overall survival rates of 92.8 and 69.3% versus 50.2 and 22.9% for the non-elevated CRP group and the elevated CRP group (p = 0.003), respectively.
  
  
  CONCLUSIONS
  CRP has a significant impact on overall survival of patients with metastatic renal cell carcinoma carcinoma treated with tyrosine kinase inhibitors.
authors.affiliation: Department of Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Saito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yuasa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kitsukawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Urakami
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Junji
authors.initials: J
authors.lastname: Yonese
authors.forename: Shunji
authors.initials: S
authors.lastname: Takahashi
authors.forename: Iwao
authors.initials: I
authors.lastname: Fukui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054316:Biomarkers, Pharmacological; D002097:C-Reactive Protein / Q000096:biosynthesis* / Q000235:genetics; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000008:administration & dosage*; D011379:Prognosis; D016016:Proportional Hazards Models; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D011758:Pyrroles / Q000008:administration & dosage*; D000077157:Sorafenib; D000077210:Sunitinib
chemical_list: D054316:Biomarkers, Pharmacological; D007211:Indoles; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D009536:Niacinamide; D002097:C-Reactive Protein; D000077157:Sorafenib; D000077210:Sunitinib