MP12-01 C-REACTIVE PROTEIN KINETICS TO PREDICT RECURRENCE AFTER RADICAL SURGERY FOR HIGH-RISK RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyCME1 May 2022MP12-01 C-REACTIVE PROTEIN KINETICS TO PREDICT RECURRENCE AFTER RADICAL SURGERY FOR HIGH-RISK RENAL CELL CARCINOMA Yudai Ishiyama, Tsunenori Kondo, Hiroki Ishihara, Kazuhiko Yoshida, Junpei Iizuka, Kazunari Tanabe, and Toshio Takagi Yudai IshiyamaYudai Ishiyama More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Hiroki IshiharaHiroki Ishihara More articles by this author , Kazuhiko YoshidaKazuhiko Yoshida More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Kazunari TanabeKazunari Tanabe More articles by this author , and Toshio TakagiToshio Takagi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002534.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: With new options appearing in adjuvant setting, clinical biomarkers to predict recurrence after radical surgery for high-risk renal cell carcinoma (hrRCC) is in need but scarcely investigated. We aimed to verify the predictive value of perioperative C-reactive protein (CRP) kinetics on RCC recurrence. METHODS: We retrospectively evaluated 154 patients who underwent curative surgery for high-risk (≥pT3 or N0-2 and M0) RCC at two institutions between 2008 and 2020. Serum CRP (mg/dL) within one months before (baseline) and within three months (post) after surgery were obtained. Patients were classified into Normal (<0.5 at baseline) and High (≥0.5 at baseline) according to baseline CRP. The High group were further classified into Normalized (<0.5 at post) or non-normalized (≥0.5 at post), and recurrence-free survival (RFS) was compared between groups. Factors for RFS were further analyzed using multivariable Cox hazards model. C-index for accuracy of predicting RFS was compared with and without addition or CRP kinetics to preexisting models. RESULTS: The RFS was significantly shorter in High (n=72, 46.8) compared to Normal (n=82, 53.2%) group (9.7 vs. 66.7 months, p <0.001). Within High group, non-normalized (n=27, 17.5%) patients showed significantly shorter RFS compared to Normalized (n=45, 29.2%) group (6.2 vs. 10.0, p=0.013). In the multivariable analysis both baseline CRP (HR: 2.05, p=0.003) and kinetics (HR: 2.62, p <0.001) effectively predicted RFS, with HR being higher for kinetics. Higher C-index improvement was observed with CRP kinetics than the baseline CRP levels when added to factors included in Karakiewicz and UCLA Integrated Staging System models. CONCLUSIONS: CRP kinetics effectively predict RCC recurrence after surgery, and may aid in decision-making for adjuvant systemic therapy. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e165 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yudai Ishiyama More articles by this author Tsunenori Kondo More articles by this author Hiroki Ishihara More articles by this author Kazuhiko Yoshida More articles by this author Junpei Iizuka More articles by this author Kazunari Tanabe More articles by this author Toshio Takagi More articles by this author Expand All Advertisement PDF DownloadLoading ...