Department of Urology, Osaka Medical College, Takatsuki City, Osaka, Japan.
Department of Urology, Osaka Medical College, Takatsuki City, Osaka, Japan; Translational Research Program, Osaka Medical College, Takatsuki City, Osaka, Japan.
Urol Oncol. 2019 Nov;37(11):812.e1-812.e8. doi: 10.1016/j.urolonc.2019.04.002. Epub 2019 Apr 30.
The C-reactive protein to albumin ratio (CAR) has been shown to provide prognostic information in several cancers. The objective in the study is to examine the prognostic value of CAR in patients with RCC who underwent nephrectomy.
The record data from multi-institutional study of 1,028 patients was analyzed in the study. The cut-off value of the CAR was defined by receive operating characteristic (ROC) analysis. Overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were evaluated, and univariate and multivariate analyses were conducted to assess the predictive value of the variables including CAR.
The optimal cut-off value of 0.073 in CAR was defined according to the ROC analysis. The AUC in CAR for CSS was greater than that of NLR and PLR, and that for RFS was also greater than GPS and mGPS. Multivariate analysis demonstrated that the CAR was an independent prognostic factor for OS (P < 0.001), CSS (P < 0.001) in total cohort and RFS (P = 0.029) in nonmetastatic cohort.
The findings of the present study suggested that the preoperative CAR is an independent prognostic indicator of OS, CSS and RFS for patients with RCC. Since CAR can be assessed prior to surgery, clinicians should this take into account for the treatment decision making.
C 反应蛋白与白蛋白比值(CAR)已在多种癌症中显示出提供预后信息的能力。本研究旨在探讨 CAR 在接受肾切除术的 RCC 患者中的预后价值。
对来自多机构的 1028 例患者的记录数据进行了分析。通过接收者操作特征(ROC)分析定义了 CAR 的截止值。评估了总生存期(OS)、癌症特异性生存期(CSS)和无复发生存期(RFS),并进行了单变量和多变量分析,以评估包括 CAR 在内的变量的预测价值。
根据 ROC 分析,CAR 的最佳截止值为 0.073。CAR 对 CSS 的 AUC 大于 NLR 和 PLR,对 RFS 的 AUC 也大于 GPS 和 mGPS。多变量分析表明,CAR 是总队列中 OS(P < 0.001)、CSS(P < 0.001)和非转移性队列中 RFS(P = 0.029)的独立预后因素。
本研究的结果表明,术前 CAR 是 RCC 患者 OS、CSS 和 RFS 的独立预后指标。由于 CAR 可在手术前进行评估,临床医生应将其纳入治疗决策。