Abstract
The present study aimed to investigate the impact of pre-treatment C-reactive protein (CRP) levels on the prediction of prognosis in patients with metastatic renal cell carcinoma (mRCC), who were classified as intermediate-risk patients using the Memorial Sloan Kettering Cancer Center (MSKCC) risk classification and who received molecular targeted therapy. The oncological outcome of 140 patients with mRCC who underwent molecular targeted therapy was analyzed. Patients were divided into favorable-, intermediate- and poor-risk groups (groups F, I and P, respectively) based on the MSKCC risk classification. The patients in group I were then further classified into two groups based on pre-treatment serum CRP levels. The overall survival (OS) rates of the patients in these groups were then assessed. The OS rate of the patients in group I with normal pre-treatment CRP levels was found to be significantly increased compared with that of patients with high pre-treatment CRP levels (P<0.0001), while there was no significant difference in the OS rate in the patients with normal pre-treatment CRP levels in group I compared with those in group F. Multivariate analyses revealed that high pre-treatment CRP levels were an independent prognostic factor for OS in the patients in group I (P<0.0001; hazard ratio, 3.898). Thus, pre-treatment CRP levels may be a candidate predictor for OS in patients with intermediate-risk mRCC.
Highlights
In the European population, renal cell carcinoma (RCC) accounts for 2% of all new cancer cases and 25% of patients with RCC have metastases at initial presentation [1]
The present study elucidated the efficacy of using pre‐treatment C‐reactive protein (CRP) levels to further classify the Memorial Sloan Kettering Cancer Center (MSKCC) risk classification's intermediate‐risk group into two subgroups with significantly different prognoses in the molecular targeted therapy era
Patil et al [19] analyzed prognostic factors in a randomized study using sunitinib or interferon‐α and demonstrated the use of the same five factors used in the MSKCC risk classification system
Summary
In the European population, renal cell carcinoma (RCC) accounts for 2% of all new cancer cases and 25% of patients with RCC have metastases at initial presentation [1]. One of the most well‐established classification systems for patients with mRCC is the Memorial Sloan Kettering Cancer Center (MSKCC) system reported by Motzer et al [10] in 1999 and modified in 2002 [11]. In the modified classification system, patients are classified into three groups based on the following five risk factors for short survival: Low Karnofsky performance status (10 mg/dl) and short time from diagnosis to the initiation of targeted therapy (
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