MP77-19 THE PREDICTIVE VALUE OF C-REACTIVE PROTEIN FOR PROGNOSIS IN PATIENTS WITH METASTATIC UPPER TRACT UROTHELIAL CARCINOMA TREATED WITH CISPLATIN-BASED CHEMOTHERAPY FOLLOWING RADICAL NEPHROURETERECTOMY: MULTI-INSTITUTIONAL STUDY

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Tumors II1 Apr 2014MP77-19 THE PREDICTIVE VALUE OF C-REACTIVE PROTEIN FOR PROGNOSIS IN PATIENTS WITH METASTATIC UPPER TRACT UROTHELIAL CARCINOMA TREATED WITH CISPLATIN-BASED CHEMOTHERAPY FOLLOWING RADICAL NEPHROURETERECTOMY: MULTI-INSTITUTIONAL STUDY Jun Obata, Eiji Kikuchi, Nobuyuki Tanaka, Suguru Shirotake, Kazuhiro Matsumoto, Masahumi Oyama, Kent Kanao, Hiroaki Kobayashi, Yasumasa Miyazaki, Hiroki Ide, Katsura Ishioka, Akira Miyajima, Tetsuo Momma, Ken Nakagawa, and Mototsugu Oya Jun ObataJun Obata More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Nobuyuki TanakaNobuyuki Tanaka More articles by this author , Suguru ShirotakeSuguru Shirotake More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto More articles by this author , Masahumi OyamaMasahumi Oyama More articles by this author , Kent KanaoKent Kanao More articles by this author , Hiroaki KobayashiHiroaki Kobayashi More articles by this author , Yasumasa MiyazakiYasumasa Miyazaki More articles by this author , Hiroki IdeHiroki Ide More articles by this author , Katsura IshiokaKatsura Ishioka More articles by this author , Akira MiyajimaAkira Miyajima More articles by this author , Tetsuo MommaTetsuo Momma More articles by this author , Ken NakagawaKen Nakagawa More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2482AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To our knowledge, no studies have evaluated the prognostic significance of blood-based markers in patients with metastatic upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) who were treated with systemic chemotherapy. Serum C-reactive protein (CRP) is one particular non-specific marker of systemic inflammation and is investigated as a prognostic value in some malignancies. The aim of the present study was to investigate the prognostic impact of serum CRP in metastatic UTUC after RNU treated with cisplatin-based chemotherapy using a multi-institutional cohort of patients. METHODS From among 707 patients who underwent RNU for UTUC at our 10 Japanese institutions between 1993 and 2010, we retrospectively collected data on 204 patients who subsequently had metastasis. We focused particularly on 93 metastatic patients treated with cisplatin-based chemotherapy and had serum CRP data at metastasis. The associations between CRP level at metastasis or other clinicopathological factors and patient outcome were assessed. A serum CRP level of >0.50 mg/dl was defined as elevated. RESULTS CRP level at metastasis was elevated in 31 patients (33.3%) and CRP elevation was significantly associated with gender, liver metastasis, bone metastasis and the number of recurrence sites. Multivariate analysis showed that CRP elevation at metastasis was the strongest predictor for cancer-specific mortality following systemic chemotherapy (Hazard ratio =4.31), followed by treatment with adjuvant chemotherapy after RNU, performance status, and the number of recurrence sites. The 1- and 3-year cancer-specific survival rates were 78.4% and 18.9% in patients with CRP level ≤0.50 mg/dl, and 30.2% and 3.8% in those with CRP level >0.50 mg/dl (p<0.001). Furthermore, according to the current four significant variables, patients were classified into three prognostic groups; low-risk (27 patients with no risk factors), intermediate-risk (59 patients with one or two risk factors) and high-risk (7 patients with three or four risk factors) groups. There were significant differences in the survival curves among the three groups (p<0.001). CONCLUSIONS Serum CRP could provide useful information on cancer-specific mortality in metastatic UTUC patients after RNU treated with systemic chemotherapy. We propose that the present study may assist in providing more appropriate patient counseling and establishing follow-up protocol. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e919 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jun Obata More articles by this author Eiji Kikuchi More articles by this author Nobuyuki Tanaka More articles by this author Suguru Shirotake More articles by this author Kazuhiro Matsumoto More articles by this author Masahumi Oyama More articles by this author Kent Kanao More articles by this author Hiroaki Kobayashi More articles by this author Yasumasa Miyazaki More articles by this author Hiroki Ide More articles by this author Katsura Ishioka More articles by this author Akira Miyajima More articles by this author Tetsuo Momma More articles by this author Ken Nakagawa More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...