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Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma

PURPOSE: To elucidate the prognostic value of systemic inflammatory response in patients with metastatic renal cell carcinoma (mRCC) who are treated with sunitinib, we evaluated the prognostic role of C-reactive protein (CRP) kinetics. This study also compared prognostic models containing CRP kineti...

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Autores principales: Wang, Beihe, Gu, Weijie, Wan, Fangning, Shi, Guohai, Ye, Dingwei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442152/
https://www.ncbi.nlm.nih.gov/pubmed/29570259
http://dx.doi.org/10.1590/S1677-5538.IBJU.2017.0500
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author Wang, Beihe
Gu, Weijie
Wan, Fangning
Shi, Guohai
Ye, Dingwei
author_facet Wang, Beihe
Gu, Weijie
Wan, Fangning
Shi, Guohai
Ye, Dingwei
author_sort Wang, Beihe
collection PubMed
description PURPOSE: To elucidate the prognostic value of systemic inflammatory response in patients with metastatic renal cell carcinoma (mRCC) who are treated with sunitinib, we evaluated the prognostic role of C-reactive protein (CRP) kinetics. This study also compared prognostic models containing CRP kinetics and neutrophil-to-lymphocyte ratio (NLR) kinetics. MATERIALS AND METHODS: A consecutive cohort of 94 patients with mRCC who were treated with sunitinib was retrospectively included from Fudan University Shanghai Cancer Center. According to dynamic changes in CRP and the NLR, patients were divided into three groups for analysis of CRP and NLR kinetics. The associations between survival and potential prognostic factors were assessed. The incremental value of prognostication was evaluated. RESULTS: A significant difference (P<0.001) in overall survival (OS) was observed among the three groups of CRP kinetics. The median OS of the non-elevated group was nearly 1.3-fold longer than that of the normalized group (33.0 vs. 26.3 months), and two times longer than that of the non-normalized group (33.0 vs. 14.0 months). Multivariate analysis showed that CRP and NLR kinetics were independent prognostic indicators. The model containing CRP kinetics had a better predictive accuracy than that with NLR kinetics, which was supported by the C-index (0.731 vs. 0.684) and the likelihood ratio χ(2) test (79.9% vs. 44.9%). CONCLUSION: Our study suggests that dynamic changes in CRP can better predict survival in patients with mRCC who are treated with sunitinib. Routine assessment of CRP before and after targeted therapy would help identify patients at risk of a poor outcome.
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spelling pubmed-64421522019-04-05 Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma Wang, Beihe Gu, Weijie Wan, Fangning Shi, Guohai Ye, Dingwei Int Braz J Urol Original Article PURPOSE: To elucidate the prognostic value of systemic inflammatory response in patients with metastatic renal cell carcinoma (mRCC) who are treated with sunitinib, we evaluated the prognostic role of C-reactive protein (CRP) kinetics. This study also compared prognostic models containing CRP kinetics and neutrophil-to-lymphocyte ratio (NLR) kinetics. MATERIALS AND METHODS: A consecutive cohort of 94 patients with mRCC who were treated with sunitinib was retrospectively included from Fudan University Shanghai Cancer Center. According to dynamic changes in CRP and the NLR, patients were divided into three groups for analysis of CRP and NLR kinetics. The associations between survival and potential prognostic factors were assessed. The incremental value of prognostication was evaluated. RESULTS: A significant difference (P<0.001) in overall survival (OS) was observed among the three groups of CRP kinetics. The median OS of the non-elevated group was nearly 1.3-fold longer than that of the normalized group (33.0 vs. 26.3 months), and two times longer than that of the non-normalized group (33.0 vs. 14.0 months). Multivariate analysis showed that CRP and NLR kinetics were independent prognostic indicators. The model containing CRP kinetics had a better predictive accuracy than that with NLR kinetics, which was supported by the C-index (0.731 vs. 0.684) and the likelihood ratio χ(2) test (79.9% vs. 44.9%). CONCLUSION: Our study suggests that dynamic changes in CRP can better predict survival in patients with mRCC who are treated with sunitinib. Routine assessment of CRP before and after targeted therapy would help identify patients at risk of a poor outcome. Sociedade Brasileira de Urologia 2019 /pmc/articles/PMC6442152/ /pubmed/29570259 http://dx.doi.org/10.1590/S1677-5538.IBJU.2017.0500 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Wang, Beihe
Gu, Weijie
Wan, Fangning
Shi, Guohai
Ye, Dingwei
Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma
title Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma
title_full Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma
title_fullStr Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma
title_full_unstemmed Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma
title_short Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma
title_sort prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442152/
https://www.ncbi.nlm.nih.gov/pubmed/29570259
http://dx.doi.org/10.1590/S1677-5538.IBJU.2017.0500
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