MP27-07 APPARENT DIFFUSION COEFFICIENT AS A PROGNOSTIC BIOMARKER OF UPPER URINARY TRACT CANCER

Abstract

INTRODUCTION AND OBJECTIVES: Several studies have shown the impact of systemic inflammation on the prognosis in patients with various types of cancers, including urothelial carcinoma (UC). The aim of this study was to evaluate the prognostic significance of pretreatment inflammatory markers in patients with metastatic UC who underwent first-line gemcitabine plus cisplatin (GC) chemotherapy. METHODS: We reviewed the medical records of 214 metastatic UC patients who received first-line GC at 14 institutions between 2005 and 2014. The associations of pretreatment clinical factors, including the neutrophil-to-lymphocyte ratio (NLR), derived NLR, platelet-tolymphocyte ratio, Onodera’s prognostic nutritional index and C-reactive protein (CRP), with progression-free survival (PFS) and overall survival (OS) were assessed. The Cox proportional hazards model was used for multivariate analysis. RESULTS: After excluding 27 patients with missing data, 187 patients were finally enrolled. The median PFS and OS were 7.5 months (IQR 3.6-11.9) and 11.7 months (IQR 7.3-19.9), respectively. Multivariate analysis showed that pretreatment CRP 1.0 mg/dL and liver or bone metastasis were independent poor prognostic factors for PFS and OS (Table). A prognostic model predicting OS was constructed based on the number of these three variables present (0, 1 and 2). The classified patients showed significantly different OS (p < 0.0001, log-rank test, Figure) and Harrell’s concordance index was 0.66 (95%CI 0.58 0.74). CONCLUSIONS: Pretreatment CRP elevation is an independent poor prognostic factor for mUC in patients undergoing first-line GC chemotherapy. Our newly developed prognostic model using the pretreatment CRP is a good discriminator of OS in metastatic UC patients. Source of Funding: none