A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma
Objective: Several inflammatory markers have been studied as potential biomarkers in renal cell carcinoma (RCC), however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies. We hypothesize that a combination of specific inflammatory markers into an RCC Inf...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-10-01
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| Series: | Asian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388217300450 |
| _version_ | 1819112491627577344 |
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| author | Rishi R. Sekar Dattatraya Patil Yoram Baum Jeffrey Pearl Anna Bausum Mehmet A. Bilen Omer Kucuk Wayne B. Harris Bradley C. Carthon Mehrdad Alemozaffar Christopher P. Filson John G. Pattaras Peter T. Nieh Kenneth Ogan Viraj A. Master |
| author_facet | Rishi R. Sekar Dattatraya Patil Yoram Baum Jeffrey Pearl Anna Bausum Mehmet A. Bilen Omer Kucuk Wayne B. Harris Bradley C. Carthon Mehrdad Alemozaffar Christopher P. Filson John G. Pattaras Peter T. Nieh Kenneth Ogan Viraj A. Master |
| author_sort | Rishi R. Sekar |
| collection | DOAJ |
| description | Objective: Several inflammatory markers have been studied as potential biomarkers in renal cell carcinoma (RCC), however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies. We hypothesize that a combination of specific inflammatory markers into an RCC Inflammatory Score (RISK) could serve as a rigorous prognostic indicator of overall survival (OS) in patients with clear cell and non-clear cell RCC.
Methods: Combination of preoperative C-reactive protein (CRP), albumin, erythrocyte sedimentation rate (ESR), corrected calcium, and aspartate transaminase to alanine transaminase (AST/ALT) ratio was used to develop RISK. RISK was developed using grid-search methodology, receiver-operating-characteristic (ROC) analysis, and sensitivity-specificity trade-off analysis. Prognostic value of RISK was analyzed using the Kaplan–Meier method and Cox proportional regression models. Predictive accuracy was compared with RISK to Size, Size, Grade, and Necrosis (SSIGN) score, University of California-LOS Angeles (UCLA) Integrated Staging System (UISS), and Leibovich Prognosis Score (LPS).
Results: Among 391 RCC patients treated with nephrectomy, area under the curve (AUC) for RISK was 0.783, which was comparable to SSIGN (AUC 0.776, p = 0.82) and UISS (AUC 0.809, p = 0.317). Among patients with localized disease, AUC for RISK and LPS was 0.742 and 0.706, respectively (p = 0.456). On multivariate analysis, we observed a step-wise statistically significant inverse relationship between increasing RISK group and OS (all p < 0.001).
Conclusion: RISK is an independent and significant predictor of OS for patients treated with nephrectomy for clear cell and non-clear cell RCC, with accuracy comparable to other histopathological prognostic tools. |
| first_indexed | 2024-12-22T04:14:21Z |
| format | Article |
| id | doaj.art-c52e52aa4f834a8889b9e302f85ca1c4 |
| institution | Directory Open Access Journal |
| issn | 2214-3882 |
| language | English |
| last_indexed | 2024-12-22T04:14:21Z |
| publishDate | 2017-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj.art-c52e52aa4f834a8889b9e302f85ca1c42022-12-21T18:39:27ZengElsevierAsian Journal of Urology2214-38822017-10-014423023810.1016/j.ajur.2017.04.002A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinomaRishi R. Sekar0Dattatraya Patil1Yoram Baum2Jeffrey Pearl3Anna Bausum4Mehmet A. Bilen5Omer Kucuk6Wayne B. Harris7Bradley C. Carthon8Mehrdad Alemozaffar9Christopher P. Filson10John G. Pattaras11Peter T. Nieh12Kenneth Ogan13Viraj A. Master14Department of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USADepartment of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USADepartment of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USADepartment of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USADepartment of Urology, Emory University School of Medicine, Atlanta, GA, USAObjective: Several inflammatory markers have been studied as potential biomarkers in renal cell carcinoma (RCC), however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies. We hypothesize that a combination of specific inflammatory markers into an RCC Inflammatory Score (RISK) could serve as a rigorous prognostic indicator of overall survival (OS) in patients with clear cell and non-clear cell RCC. Methods: Combination of preoperative C-reactive protein (CRP), albumin, erythrocyte sedimentation rate (ESR), corrected calcium, and aspartate transaminase to alanine transaminase (AST/ALT) ratio was used to develop RISK. RISK was developed using grid-search methodology, receiver-operating-characteristic (ROC) analysis, and sensitivity-specificity trade-off analysis. Prognostic value of RISK was analyzed using the Kaplan–Meier method and Cox proportional regression models. Predictive accuracy was compared with RISK to Size, Size, Grade, and Necrosis (SSIGN) score, University of California-LOS Angeles (UCLA) Integrated Staging System (UISS), and Leibovich Prognosis Score (LPS). Results: Among 391 RCC patients treated with nephrectomy, area under the curve (AUC) for RISK was 0.783, which was comparable to SSIGN (AUC 0.776, p = 0.82) and UISS (AUC 0.809, p = 0.317). Among patients with localized disease, AUC for RISK and LPS was 0.742 and 0.706, respectively (p = 0.456). On multivariate analysis, we observed a step-wise statistically significant inverse relationship between increasing RISK group and OS (all p < 0.001). Conclusion: RISK is an independent and significant predictor of OS for patients treated with nephrectomy for clear cell and non-clear cell RCC, with accuracy comparable to other histopathological prognostic tools.http://www.sciencedirect.com/science/article/pii/S2214388217300450Renal cell carcinomaInflammationPrognosisBiomarker |
| spellingShingle | Rishi R. Sekar Dattatraya Patil Yoram Baum Jeffrey Pearl Anna Bausum Mehmet A. Bilen Omer Kucuk Wayne B. Harris Bradley C. Carthon Mehrdad Alemozaffar Christopher P. Filson John G. Pattaras Peter T. Nieh Kenneth Ogan Viraj A. Master A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma Asian Journal of Urology Renal cell carcinoma Inflammation Prognosis Biomarker |
| title | A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma |
| title_full | A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma |
| title_fullStr | A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma |
| title_full_unstemmed | A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma |
| title_short | A novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma |
| title_sort | novel preoperative inflammatory marker prognostic score in patients with localized and metastatic renal cell carcinoma |
| topic | Renal cell carcinoma Inflammation Prognosis Biomarker |
| url | http://www.sciencedirect.com/science/article/pii/S2214388217300450 |
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