Department of Urology, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo 113-8510, Japan.
Br J Cancer. 2012 Sep 25;107(7):1031-6. doi: 10.1038/bjc.2012.254. Epub 2012 Aug 23.
The purpose of this study is to investigate the prognostic impact of C-reactive protein (CRP) on patients with advanced urothelial carcinoma and to develop a novel nomogram predicting survival.
A total of 223 consecutive patients were treated at Tokyo Medical and Dental Hospital. A nomogram incorporating V was developed based on the result of a Cox proportional hazards model. Its efficacy and clinical usefulness was evaluated by concordance index (c-index) and decision curve analysis.
Of the 223 patients, 184 (83%) died of cancer. Median follow-up periods of patients who died and those who remained alive were 5 and 11 months, respectively. We developed a novel nomogram incorporating Eastern Cooperative Oncology Group Performance Status, presence of visceral metastasis, haemoglobin and age. The c-index of the nomogram predicting survival probability 6 and 12 months after diagnosis was 0.788 and 0.765, respectively. Decision curve analyses revealed that the novel nomogram incorporating CRP had a superior net benefit than that without CRP for most of the examined probabilities.
We demonstrated the prognostic impact of CRP that improved the predictive accuracy of a nomogram for survival probability in patients with advanced urothelial carcinoma.
本研究旨在探讨 C 反应蛋白（CRP）对晚期尿路上皮癌患者预后的影响，并建立一种新的预测生存的列线图。
共对东京医科齿科大学医院的 223 例连续患者进行了治疗。根据 Cox 比例风险模型的结果，建立了一个包含 V 的列线图。通过一致性指数（c-index）和决策曲线分析评估其疗效和临床实用性。
223 例患者中，184 例（83%）死于癌症。死亡患者和存活患者的中位随访期分别为 5 个月和 11 个月。我们开发了一种新的列线图，纳入了东部合作肿瘤学组表现状态、内脏转移、血红蛋白和年龄。预测诊断后 6 个月和 12 个月生存率的列线图的 c-index 分别为 0.788 和 0.765。决策曲线分析表明，对于大多数检查概率，包含 CRP 的新列线图比不包含 CRP 的列线图具有更高的净收益。
我们证明了 CRP 的预后影响，提高了预测晚期尿路上皮癌患者生存概率的列线图的预测准确性。
