Significance of Erythrocyte Sedimentation Rate and C-reactive Protein as Predictive Factors for Prognosis in Non-metastatic Renal Cell Carcinoma

Abstract

Purpose: This study was performed to investigate the significance of preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and postoperative ESR and CRP nadir as predictive factors for prognosis in patients with non-metastatic renal cell carcinoma (RCC). Materials and Methods: In 66 patients with non-metastatic RCC for whom ESR and CRP could be measured before radical nephrectomy and during follow-up, the preoperative ESR, preoperative CRP, postoperative ESR nadir and postoperative CRP nadir were compared with the clinicopathological variables. Results: Patients with elevated preoperative ESR or CRP levels were more likely to have tumors with adverse features, including larger tumor size, higher T stage, higher nuclear grade and more frequent metastasis at follow-up, as compared to those patients with lower preoperative ESR or CRP levels, respectively. Patients with an elevated postoperative CRP nadir developed metastasis more frequently at follow-up as compared to those patients with a lower level of postoperative CRP nadir. The univariate analyses identified tumor size, T stage, preoperative ESR, preoperative CRP and postoperative CRP nadir as significant prognostic factors for recurrence-free survival. Conclusions: Elevated preoperative ESR, preoperative CRP and postoperative CRP nadir are associated with a worse prognosis and a higher recurrence rate in patients with non-metastatic RCC, suggesting that ESR and CRP are valuable prognostic indicators in RCC. (Korean J Urol 2006; 47:1059-1064) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ