Kalogirou Charis, Mulfinger Philipp, Sokolakis Ioannis, Krebs Markus, Kübler Hubert, Riedmiller Hubertus, Vergho Daniel
Department of Urology and Paediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany.
Urol Int. 2017;99(3):297-307. doi: 10.1159/000475932. Epub 2017 Jun 17.
To validate preoperative C-reactive protein (CRP) levels as a prognostic marker for survival in a metastasized renal cell carcinoma (mRCC) patient cohort receiving cytoreductive nephrectomy (CN).
By chart review, 146 mRCC patients receiving CN at our tertiary referral centre from 1997 to 2015 were identified retrospectively. All relevant clinicopathological features including laboratory parameters were collected and correlated to overall survival, progression-free survival and cancer-specific survival (CSS). The mean follow-up was 23 months (range 1-168 months).
Besides the already established scoring systems like the MSKCC criteria, an elevated preoperative CRP level (≥0.5 mg/dL) was an independent predictor of CSS in our study group including the chosen postoperative adjuvant therapies (TKI vs. immunotherapy vs. others). With regard to morbidity, patients with a good performance status, small tumour size and adequate renal function/haematopoiesis experienced less complication rates, thereby profiting more from CN.
Our data provide indication that preoperative CRP levels should be implemented in nomograms regarding the outcome prediction in mRCC to identify candidates likely to profit from CN.
验证术前C反应蛋白（CRP）水平作为接受减瘤性肾切除术（CN）的转移性肾细胞癌（mRCC）患者队列生存预后标志物的有效性。
通过病历回顾，回顾性确定了1997年至2015年在我们三级转诊中心接受CN的146例mRCC患者。收集所有相关的临床病理特征，包括实验室参数，并将其与总生存期、无进展生存期和癌症特异性生存期（CSS）相关联。平均随访时间为23个月（范围1 - 168个月）。
除了已确立的评分系统如MSKCC标准外，在我们的研究组中，包括所选的术后辅助治疗（酪氨酸激酶抑制剂[TKI]与免疫治疗与其他治疗），术前CRP水平升高（≥0.5mg/dL）是CSS的独立预测因素。关于发病率，身体状况良好、肿瘤体积小且肾功能/造血功能良好的患者并发症发生率较低，因此从CN中获益更多。
我们的数据表明，术前CRP水平应纳入mRCC预后预测的列线图中，以识别可能从CN中获益的患者。
