title: Serum C-reactive protein level is a significant prognostic indicator in patients with advanced urothelial cancer treated with gemcitabine-cisplatin or carboplatin - preliminary results.
abstract: BACKGROUND
  This study determines prognostic factors in patients with advanced urothelial cancer (UC) treated with gemcitabine-cisplatin or carboplatin (GC).
  
  
  METHODS
  The clinical records of 30 patients with advanced UC treated with GC were retrospectively reviewed. Twenty-six patients (86.7%) had previously undergone other chemotherapies. Hematological parameters such as: neutrophil, lymphocyte and platelet counts; hemoglobin, C-reactive protein (CRP), and albumin levels; pain score; primary tumor site; tumor grade; type of platinum anti-cancer drug; and performance status before treatment were evaluated. Survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. Multivariate analysis was performed using a Cox proportional hazards model.
  
  
  RESULTS
  The median cancer-specific survival (CSS) was 12.5 months. The overall response rate (ORR) was 30.0%. The survival rates of patients with low serum albumin (<3.5 g/dL; P = 0.008), low hemoglobin (<10.1 mg/dL; P = 0.025), high CRP (>1.0 mg/dL; P = 0.001), and a positive pain score (P = 0.002) were significantly worse than those with better blood values and pain scores. Multivariate analysis revealed serum CRP level as an independent prognostic indicator with a hazard ratio of 4.608 (95% confidence interval (CI) of 1.763-12.047; P = 0.002).
  
  
  CONCLUSIONS
  Pretreatment serum CRP levels could be an accurate biomarker of the survival of patients with advanced UC before GC therapy. Although this is a preliminary study with a small sample size, these results seem to be very useful in clinical practice and our findings should be confirmed in a larger group of patients.
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Morizane
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Iwamoto
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Yao
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Isoyama
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Sejima
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Tottori, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takenaka
keywords: CRP; biomarker; chemotherapy; peripheral blood value; survival