C-reactive protein-albumin ratio as a prognostic factor in renal cell carcinoma - A data from multi-institutional study in Japan
C-reactive protein-albumin ratio as a prognostic factor in renal cell carcinoma - A data from multi-institutional study in Japan
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DOI：
10.1016/j.urolonc.2019.04.002
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发表时间：
2019-11-01
影响因子：
2.7
通讯作者：
Azuma, Haruhito
中科院分区：
文献类型：
--
作者：
Tsujino, Takuya;Komura, Kazumasa;Azuma, Haruhito
引言：C-反应蛋白与白蛋白比值（CAR）已被证明可提供多种癌症的预后信息。本研究的目的是探讨CAR在接受肾切除术的RCC患者中的预后价值。材料和方法：本研究分析了1,028例患者的多机构研究的记录数据。通过受试者工作特征（ROC）分析确定CAR的临界值。对总生存期（OS）、肿瘤特异性生存期（CSS）和无复发生存期（RFS）进行评估，并对CAR等指标进行单因素和多因素分析。结果：根据ROC曲线分析，确定CAR的最佳截断值为0.073。CSS在CAR中的AUC大于NLR和PLR，RFS也大于GPS和mGPS。多因素分析显示，术前CAR是影响总生存期（P < 0.001）、总CSS（P < 0.001）和无转移组RFS（P = 0.029）的独立预后因素。由于CAR可以在手术前进行评估，因此临床医生在制定治疗决策时应考虑到这一点。(C)2019爱思唯尔公司All rights reserved.
Introduction: 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.Material and Methods: 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.Result: 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.Conclusion: 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) 2019 Elsevier Inc. All rights reserved.