Document Detail

Prognostic impact of postoperative C-reactive protein level in patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy.
MedLine Citation:
PMID:  18550105     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We explored the prognostic impact of C-reactive protein status in patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy. MATERIALS AND METHODS: The oncological outcome of 40 patients with metastatic renal cell carcinoma (TxpN1M0, TxNxM1) who underwent cytoreductive nephrectomy was analyzed. The C-reactive protein level was measured before and 1 month after cytoreductive nephrectomy. The normal value of C-reactive protein was considered less than 0.5 mg/dl. RESULTS: During the median followup of 14 months 31 patients (78%) died of the disease. The preoperative C-reactive protein level was not increased in 17 of the 40 patients (nonelevated group). Of the remaining 23 patients with a preoperatively increased C-reactive protein level, after cytoreductive nephrectomy the C-reactive protein level normalized in 17 (normalized group). However, in the remaining 6 patients the C-reactive protein level did not normalize and remained high during followup (nonnormalized group). All of the patients in nonnormalized group died of the disease within 1 year. The overall survival rate of the nonnormalized group was significantly worse than that of the other 2 groups (p <0.0001). No significant difference was found in terms of overall survival rate between the normalized and nonelevated groups (p = 0.22). Multivariate analysis demonstrated that nonnormalized C-reactive protein (p <0.0001), absence of metastatectomy (p = 0.005), poorer performance status (p = 0.006) and bone metastases (p = 0.023) were independent factors for predicting poorer overall survival. CONCLUSIONS: The current study indicated that C-reactive protein kinetics would predict the clinical course of patients with metastatic renal cell carcinoma who underwent cytoreductive nephrectomy. Larger confirmatory studies would be warranted to validate the current results.
Manabu Tatokoro; Kazutaka Saito; Yasumasa Iimura; Yasuhisa Fujii; Satoru Kawakami; Kazunori Kihara
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Publication Detail:
Type:  Journal Article     Date:  2008-06-11
Journal Detail:
Title:  The Journal of urology     Volume:  180     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-14     Completed Date:  2008-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  515-9     Citation Subset:  AIM; IM    
Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.
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MeSH Terms
C-Reactive Protein / analysis*
Carcinoma, Renal Cell / blood,  mortality,  secondary*,  surgery*
Kidney Neoplasms / blood*,  mortality,  pathology,  surgery*
Middle Aged
Nephrectomy / methods*,  mortality
Postoperative Period
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Survival Analysis
Treatment Outcome
Tumor Markers, Biological / blood*
Reg. No./Substance:
0/Tumor Markers, Biological; 9007-41-4/C-Reactive Protein
Comment In:
J Urol. 2008 Aug;180(2):433-4   [PMID:  18550098 ]

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