title: Preoperative butyrylcholinesterase level as an independent predictor of overall survival in clear cell renal cell carcinoma patients treated with nephrectomy.
abstract: The prognostic factors for the overall survival (OS) of clear cell renal cell carcinoma (ccRCC) patients treated with nephrectomy are not well defined. In the present study, we investigated the prognostic significance of preoperative butyrylcholinesterase (BChE) levels in 400 ccRCC patients undergoing radical or partial nephrectomy from 1992 to 2013 at our institution. Univariate and multivariate analyses were performed to determine the clinical factors associated with OS. Among the enrolled patients, 302 were diagnosed with organ-confined disease only (T1-2N0M0), 16 with lymph node metastases, and 56 with distant metastases. The median preoperative BChE level was 250 U/L (normal range, 168-470 U/L), and median follow-up period was 36 months. The 3-year OS rate in patients with preoperative BChE levels of ≥100 U/L was significantly higher than in those with levels of <100 U/L (89.3% versus 77.7%, P = 0.004). On univariate analysis, performance status; anemia; hypoalbuminemia; preoperative levels of BChE, corrected calcium, and C-reactive protein; and distant metastasis status were significantly associated with OS. Multivariate analysis revealed that preoperative BChE levels and distant metastasis status were significantly associated with OS. Our findings suggest a possible role of preoperative BChE levels as an independent predictor of OS after nephrectomy in ccRCC patients.
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Koie
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Ohyama
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Jotaro
authors.initials: J
authors.lastname: Mikami
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Iwamura
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujita
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Tendo
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Fukushi
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Hayato
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imai
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Shingo
authors.identifier: 0000-0002-0026-4079
authors.initials: S
authors.lastname: Hatakeyama
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoneyama
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kitayama
authors.affiliation: Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Zaifucho 5, Hirosaki 036-8562, Japan.
authors.forename: Kazuyoshi
authors.identifier: 0000-0001-6936-0985
authors.initials: K
authors.lastname: Hirota
mesh_terms: D000368:Aged; D002091:Butyrylcholinesterase / Q000378:metabolism*; D002292:Carcinoma, Renal Cell / Q000201:enzymology* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D002091:Butyrylcholinesterase
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