Die prognostische Wertigkeit des präoperativen C-reaktiven Proteins im Serum von Patienten mit Nierenzellkarzinom
Auch gedruckt in der BibliothekW: W-H 13.553
Rudolph, Raphael Alexander Georg
Aim of the study was the identification of independent predictors of tumorspecific survival in patients with renal cell cancer. The prognostic value of preoperative c-reactive protein was of special interest. Data of 1161 patients of two german centers who had undergone nephrectomy or nephron-sparing surgery in 1995 to 2010 were acquired. The mean follow-up time was 54.2 months. The CRP-value, stratified to three subgroups (CRP LESS-THAN OR EQUAL TO; 4mg/l, 4-10 mg/l and > 10 mg/l), was tested for dependency of age, sex, histology, side, TNM-classification and grading. We found significant univariate correlations of high preoperative CRP-values > 10 mg/l with age (p = 0.005), clear cell histology (p = 0.004), T-staging (p < 0.001), positive lymph node status (p < 0.001), positive organ metastasis status (p < 0.001) and progressed disease (p < 0.001). The 5-year cancer specific survival rates for CRP LESS-THAN OR EQUAL TO 4mg/l, 4-10 mg/l and > 10 mg/l were 89.4, 77.9, and 49.5 %, respectively (p < 0.001). Locally progressed tumors (pT3-pT4) and tumors in progressed disease (pT3-4 and/or N1 and/or M1) had higher absolute CRP-values (p < 0.001; p < 0.001). In patients with a progressed disease even a CRP-value > 4 mg/l indicated a poorer prognosis (p < 0.001). Multivariate analysis identified age (p < 0.001), posivitve lymph node status (HR 3.59; p < 0.001), positive organ metastasis status (HR 3.23; p < 0.001), grading Tumordifferenzierung (p = 0.02) and preoperative CRP (p < 0.001) as independent prognosticators for cancer specific survival. Patients with a CRP of 4-10 and >10 mg/l had a 1.67 and 2.48 fold higher risk of dying due to their tumor compared to those with a pre-operative CRP LESS-THAN OR EQUAL TO 4mg/l, respectively.
Erstellung / Fertigstellung
Normierte SchlagwörterC-reaktives Protein [GND]
C-reactive protein [MeSH]