1. The Impact of the Preoperative Serum Albumin Level and Postoperative C-Reactive Protein Nadir on the Survival of Patients with Non-Metastatic Renal Cell Carcinoma with Vessel Thrombus after Nephrectomy
- Author
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Kiminobu Arima, Yasushi Yamada, Kouhei Nishikawa, Yoshiki Sugimura, and Norihito Soga
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Urology ,medicine.medical_treatment ,C-reactive protein ,Hazard ratio ,Albumin ,medicine.disease ,Nephrectomy ,Surgery ,Oncology ,Reproductive Medicine ,Renal cell carcinoma ,medicine ,biology.protein ,Thrombus ,business ,Survival rate ,Nadir (topography) - Abstract
Purpose: To evaluate the predictors for survival in non-metastatic renal cell carcinoma (non-mRCC) associated with tumor thrombus following surgical resection. Patients and Methods: Between February 1983 and December 2009, a total of 40 patients with a diagnosis of non-mRCC (23 with pT3a pN0M0, 15 with pT3b pN0M0 and 2 patients with pT3c pN0M0) were enrolled. Various preoperative and postoperative parameters were assessed as prognostic factors. Results: In the multivariate analysis, a low level of preoperative albumin less than 35 g/l [hazard ratio (HR) 8.06] and high postoperative C-reactive protein (CRP): CRP nadir greater than 2 mg/l (HR 1.78) were identified significant risk factors for cause-specific survival. For the risk of progression-free survival, 3 factors proved to be significant independent predictors: a low preoperative albumin (HR 25.5), a high postoperative CRP nadir (HR 18.71) and low preoperative hemoglobin (HR 17.4). In 24 cases with the high preoperative CRP (> 2 mg/l), the progression-free survival rates in the low postoperative CRP nadir group achieved a significant better survival rate than the high CRP nadir group after nephrectomy (p = 0.048). Conclusion: In non-mRCC with tumor thrombus after surgical resection, a low preoperative albumin level and an elevated postoperative CRP nadir were significant independent predictors of survival.
- Published
- 2011
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