title: Erythrocyte sedimentation rate and anaemia are independent predictors of survival in patients with clear cell renal cell carcinoma.
abstract: BACKGROUND
  The 1997 international consensus conference on renal cell cancer (RCC) prognosis suggested erythrocyte sedimentation rate (ESR), alkaline phosphatase (ALP), and anaemia as prognostic biomarkers, but most studies reviewed were limited by small sample sizes.
  
  
  METHODS
  The Cox proportional hazards model was used to evaluate whether ESR, ALP, haemoglobin (Hb), and haematocrit (Hct) could predict survival outcomes in 1307 patients with clear cell RCC (ccRCC) who underwent nephrectomy during 1994-2008.
  
  
  RESULTS
  During a median follow-up of 43 months, we found that the patients with preoperative high levels of ESR, had a 2.10-fold (95% confidence interval (CI): 1.21-3.67) greater risk of dying from RCC compared with patients with low levels (normal range). Patients with preoperative anaemia, assessed by Hb and Hct, had a 3.11-fold (95% CI: 1.17-8.25) and 6.20-fold (95% CI: 2.30-16.72) greater risk of dying from other illnesses, respectively, compared with patients without anaemia. ALP levels were not associated with ccRCC patients' survival. These associations for ESR and anaemia were more pronounced in patients with body mass index (BMI) <25 compared with patients with BMI ≥ 25 kg m(-2).
  
  
  CONCLUSIONS
  Preoperative high ESR, but not ALP, was a significant predictor for cancer-specific survival among ccRCC patients. Anaemia increases the risk of death from other illness.
authors.affiliation: Women's Health Research Institute, Sookmyung Women's University, Seoul, Republic of Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Choi
authors.forename: B
authors.initials: B
authors.lastname: Park
authors.forename: K
authors.initials: K
authors.lastname: Kim
authors.forename: B C
authors.initials: BC
authors.lastname: Jeong
authors.forename: S I
authors.initials: SI
authors.lastname: Seo
authors.forename: S S
authors.initials: SS
authors.lastname: Jeon
authors.forename: H Y
authors.initials: HY
authors.lastname: Choi
authors.forename: J E
authors.initials: JE
authors.lastname: Lee
authors.forename: H M
authors.initials: HM
authors.lastname: Lee
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000740:Anemia / Q000209:etiology; D014408:Biomarkers, Tumor / Q000097:blood; D001799:Blood Sedimentation; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D000469:Alkaline Phosphatase