Prognostic value of serum creatine level in patients with vulvar cancer

Richard Schwameis,Alexander Reinthaller,Christoph Grimm,Stephan Polterauer,Lukas Hefler,Veronika Seebacher,Magdalena Postl,Samir Helmy-Bader,Christine Bekos

doi:10.1038/s41598-019-47560-3

Abstract

Vulvar cancer is a rare malignancy with poor prognosis that generally occurs in elderly patients. The individual prognosis is difficult to assess. Serum creatinine levels are frequently elevated in elderly patients. Recent evidence have shown shown that - besides indicating kidney impairment - serum creatinine levels may be used to predict the survival in cancer patients. Several studies observed an association between elevated serum creatinine levels and poor prognosis in patients with solid tumors. In this retrospective cohort study, serum creatinine levels were evaluated in 170 patients with invasive vulvar cancer. Serum creatinine levels were correlated to established clinicopathologic factors. Univariate and multivariate survival analysis were performed. Elevated serum creatinine levels (>1.2 mg/dl) were significantly associated with both poor disease specific and overall survival. Three year overall survival rates were 74.8% and 32.5% for patients with serum creatinine levels of ≤ and >1.2 mg/dl, respectively. In a multivariate survival model, serum creatinine levels were significantly associated with overall survival independent of tumor stage and patients’ age. In conclusion, pretherapeutic serum creatinine levels may be useful as an independent prognostic parameter in patients with vulvar cancer.

Highlights

Vulvar cancer is a rare gynecological malignancy with a slightly rising incidence rate[1,2]
This study was performed to assess whether pretherapeutic serum creatinine levels have a prognostic value in patients with invasive vulvar cancer and whether it might serve as a cheap, readily available prognostic parameter
A total of 171 patients had to be excluded from analysis because of either non-invasive vulvar cancer or incomplete clinical or laboratory data

Summary

Introduction

Vulvar cancer is a rare gynecological malignancy with a slightly rising incidence rate[1,2] It is associated with poor survival when compared to other gynecological malignancies. In a variety of malignancies including patients with sarcoma and urothelial carcinoma, renal impairment delineated by high serum creatinine levels has been associated with poor survival[10,11]. It seems reasonable to assess whether renal impairment reflected by elevated kidney function parameters have a prognostic value in patients suffering from vulvar cancer. This study was performed to assess whether pretherapeutic serum creatinine levels have a prognostic value in patients with invasive vulvar cancer and whether it might serve as a cheap, readily available prognostic parameter

Methods

Results

Conclusion