Abstract
ABSTRACTObjectives:To investigate whether Glasgow Prognostic Score has prognostic significance in patients with upper urinary urothelial carcinoma.Patients and methods:We retrospectively reviewed the clinical records of 74 patients with upper urinary urothelial carcinoma. We set the cut-off value for C-reactive protein as 1.0mg/dL, and 3.5mg/dL for albumin as Glasgow Prognostic Score. Their blood data including albumin and C-reactive protein for Glasgow Prognostic Score and cytokeratin 19 fragment 21-1 as a tumor marker were measured before starting treatment. The patients were stratified into three groups with Glasgow Prognostic Score: The Group-1, albumin ≥3.5g/dL and C-reactive protein < 1.0mg/dL; Group-2, albumin < 3.5g/dL or C-reactive protein ≥1.0mg/dL; Group-3, albumin < 3.5g/dL and C-reactive protein ≥1.0mg/dL.Results:The median follow-up for all patients was 26.9 months (range: 10.9-91.1 months), during which 37 (50%) patients died. There was a significant difference in the estimated survival rate among the 3 groups stratified by Glasgow Prognostic Score. The estimated survival rate in the Group-1 was significantly higher than those in Groups 2 and 3.In the univariate analysis C-reactive protein, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were significant predictors of overall survival. On the multivariate analysis, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were independently associated with shorter overall survival.Conclusion:Our review suggests Glasgow Prognostic Score may play as a prognostic predictor for upper urinary urothelial carcinoma.
Highlights
Urothelial carcinoma (UC) is the most common histological type of urinary system malignancy
Glasgow Prognostic Score (GPS) was proposed by Forrest et al, and so far, in non-small cell lung cancer [11], colon cancer [13], breast cancer [14], pancreas cancer [15], Figure 2 - Receiver operating characteristics (ROC) curve, and the area under the curve (AUC) and 95% confidence intervals (95% CI) for determining the cut-off values of predictors for overall death
GPS is calculated by two inspections, Albumin (Alb) and C-reactive protein (CRP) which are generally measured in Japan
Summary
Urothelial carcinoma (UC) is the most common histological type of urinary system malignancy. The incidence of upper urinary urothelial carcinoma (UTUC) is relatively low, comprising only 5-10% of all urothelial malignancies [1]. Ibju | InflammatIon-based scorIng in urothelial cancer the prognosis for UTUC is generally poorer than that for bladder cancer [3]; clinically effective prognostic predictors with a high specificity for UTUC has not been established such as prostate specific antigen (PSA) for prostate cancer and α-fetoprotein (AFP) or human chorionic gonadotropin (hCG) for testicular tumors. Preoperative staging of UTUC is not simple, and radical nephroureterectomy (RNU) with bladder-cuff removal is traditionally considered the standard of care for localized disease [4]. Recent advances in diagnostic imaging and endoscopic armamentarium [5] have markedly enhanced the role of kidney-sparing surgery for well-selected patients in the latest European Association of Urology (EAU) guidelines [4]
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Schedule a callMore From: International braz j urol : official journal of the Brazilian Society of Urology
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