PMID- 25138778
OWN - NLM
STAT- MEDLINE
DCOM- 20150629
LR  - 20220311
IS  - 1423-0399 (Electronic)
IS  - 0042-1138 (Linking)
VI  - 93
IP  - 3
DP  - 2014
TI  - Preoperative C-reactive protein in the serum: a prognostic biomarker for upper 
      urinary tract urothelial carcinoma treated with radical nephroureterectomy.
PG  - 352-60
LID - 10.1159/000362248 [doi]
AB  - OBJECTIVE: To investigate the impact of preoperative serum C-reactive protein 
      (CRP) on clinicopathological features and prognosis in patients with upper tract 
      urothelial cancer (UTUC) after radical nephroureterectomy (RNU). PATIENTS AND 
      METHODS: Data of 265 patients from three German centers who underwent RNU for 
      UTUC without neoadjuvant chemotherapy between 1990 and 2012 were evaluated. Mean 
      follow-up was 37 months (interquartile range 9-48). CRP was analyzed as a 
      categorical and continuous variable for the prediction of recurrence-free 
      survival (RFS), disease-specific survival (DSS) and all-cause survival (ACS) 
      using uni- and multivariate Cox regression analyses. RESULTS: The optimal cutoff 
      for CRP was calculated by the Youden index at 0.90 mg/dl. Elevated CRP was 
      significantly associated with pT3/4 and pN+ in a preoperative model including 
      age, gender, tumor multifocality, tumor localization and the Eastern Cooperative 
      Oncology Group Performance Status. In a multivariable Cox regression model 
      adjusted for features significant in univariable analysis, categorized and 
      continuous CRP levels were both independent predictors for RFS [hazard ratio (HR) 
      1.18, p = 0.050; HR 1.03, p = 0.012] and DSS (HR 1.61, p = 0.026; HR 1.06, p = 
      0.001). Continuous CRP was an independent predictor for ACS (HR 1.05, p = 0.036). 
      CONCLUSIONS: Elevated preoperative CRP is significantly associated with 
      aggressive tumor biology and an independent predictor for poor survival after 
      RNU. Preoperative serum CRP represents an easily obtainable and cost-effective 
      marker in UTUC and may help in counseling patients with regard to operative 
      management and/or adjuvant or neoadjuvant therapies.
CI  - 2014 S. Karger AG, Basel.
FAU - Aziz, Atiqullah
AU  - Aziz A
AD  - Department of Urology, Caritas St. Josef Medical Center, University of 
      Regensburg, Regensburg, Germany.
FAU - Rink, Michael
AU  - Rink M
FAU - Gakis, Georgios
AU  - Gakis G
FAU - Kluth, Luis A
AU  - Kluth LA
FAU - Dechet, Christopher
AU  - Dechet C
FAU - Miller, Florian
AU  - Miller F
FAU - Otto, Wolfgang
AU  - Otto W
FAU - Gierth, Michael
AU  - Gierth M
FAU - Denzinger, Stefan
AU  - Denzinger S
FAU - Schwentner, Christian
AU  - Schwentner C
FAU - Stenzl, Arnulf
AU  - Stenzl A
FAU - Fisch, Margit
AU  - Fisch M
FAU - Burger, Maximilian
AU  - Burger M
FAU - Fritsche, Hans-Martin
AU  - Fritsche HM
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20140819
PL  - Switzerland
TA  - Urol Int
JT  - Urologia internationalis
JID - 0417373
RN  - 0 (Biomarkers, Tumor)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Aged
MH  - Biomarkers, Tumor/*blood
MH  - C-Reactive Protein/*metabolism
MH  - Carcinoma/*blood/surgery
MH  - Chemotherapy, Adjuvant
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Germany
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoadjuvant Therapy
MH  - Neoplasm Recurrence, Local
MH  - Nephrectomy/*methods
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Urinary Bladder Neoplasms/*blood/surgery
MH  - Urothelium/pathology
EDAT- 2014/08/21 06:00
MHDA- 2015/06/30 06:00
CRDT- 2014/08/21 06:00
PHST- 2014/01/30 00:00 [received]
PHST- 2014/03/16 00:00 [accepted]
PHST- 2014/08/21 06:00 [entrez]
PHST- 2014/08/21 06:00 [pubmed]
PHST- 2015/06/30 06:00 [medline]
AID - 000362248 [pii]
AID - 10.1159/000362248 [doi]
PST - ppublish
SO  - Urol Int. 2014;93(3):352-60. doi: 10.1159/000362248. Epub 2014 Aug 19.