OP1-08 HIGH PREOPERATIVE C-REACTIVE PROTEIN VALUES PREDICT POOR SURVIVAL IN PATIENTS ON CHRONIC HEMODIALYSIS UNDERGOING NEPHRECTOMY FOR RENAL CANCER

Abstract

You have accessJournal of UrologyOutstanding Posters: Research1 Apr 2014OP1-08 HIGH PREOPERATIVE C-REACTIVE PROTEIN VALUES PREDICT POOR SURVIVAL IN PATIENTS ON CHRONIC HEMODIALYSIS UNDERGOING NEPHRECTOMY FOR RENAL CANCER Kenji Omae, Tsunenori Kondo, Kazuhiko Yoshida, Toshio Takagi, Hirohito Kobayashi, Yasunobu Hashimoto, and Kazunari Tanabe Kenji OmaeKenji Omae More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Kazuhiko YoshidaKazuhiko Yoshida More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Yasunobu HashimotoYasunobu Hashimoto More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.616AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Serum C-reactive protein (CRP) is a specific marker of systemic inflammation. Previous studies reported that pretreatment-elevated CRP level is associated with poor outcome in various malignancies, including renal cell carcinoma (RCC) in the general population. However, there is no evidence of such an association in dialysis patients. In this study, our objective is to evaluate the prognostic significance of the preoperative serum CRP level in patients with RCC related to end-stage renal disease (ESRD-RCC) requiring hemodialysis. METHODS We evaluated 315 patients with ESRD requiring hemodialysis who underwent either open or laparoscopic nephrectomy for RCC as the first treatment in our department from September 1982 to January 2013. Complete patient and tumor specific characteristics as well as preoperative CRP-levels were assessed. Patients were divided into two groups according to their preoperative CRP-level (CRP ≤ 0.5, and > 0.5 mg/dl). The mean follow-up was 68 months. RESULTS Mean age was 55.5 years old and mean duration of preoperative hemodialysis was 246 months for the entire cohort. Of the 315 patients, 257 patients (81.6%) were male. In 75 patients (23.8%) the preoperative CRP-level was over 0.5 mg/dl. The Kaplan-Meier 5-year cancer specific survival (CSS) rates were 95.2% and 69.9% in patients with a CRP ≤ 0.5, and > 0.5 mg/dl, respectively (p < 0.0001). Multivariate analysis identified the preoperative CRP-level as an independent predictor for CSS, along with a pathological TNM classification and tumor grade (CRP > 0.5: HR=3.47, 95%CI 1.35-9.18, p=0.0098). CONCLUSIONS Preoperative serum CRP level might be an independent predictor of postoperative survival in patients with ESRD-RCC requiring hemodialysis. Its routine use, together with the TNM classification and tumor grade, could allow better risk stratification and risk-adjusted follow-up of these patients. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e165 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Kenji Omae More articles by this author Tsunenori Kondo More articles by this author Kazuhiko Yoshida More articles by this author Toshio Takagi More articles by this author Hirohito Kobayashi More articles by this author Yasunobu Hashimoto More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...