Prognostic model using postoperative normalization of C-reactive protein levels in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy

Authors

  • Jun Teishima Kobe City Medical Center West Hospital, Kobe, Japan
  • Junichiro Hirata Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital
  • Takuya Toge Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital
  • Riku Uematsu Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital
  • Yoshie Mita Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital
  • Takahiko Yoshii Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital
  • Ichiro Nakamura Department of Urology, Kobe City Hospital Organization Kobe City Medical Center West Hospital

DOI:

https://doi.org/10.5489/cuaj.8393

Keywords:

prognostic model, upper tract urothelial carcinoma, radical nephroureterectomy, C-reactive protein

Abstract

INTRODUCTION: To improve the prediction of outcomes in patients who will undergo radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), we investigated the preoperative prognostic factors and developed a risk classification model.

METHODS: A total of 144 patients who underwent RNU with history of neither neoadjuvant nor adjuvant chemotherapy between 2008 and 2022 were retrospectively reviewed. Associations between perioperative/clinicopathologic factors and outcomes, including cancer- specific survival (CSS), were assessed. We specifically focused on preoperative serum C-reactive protein (CRP) and its postoperative normalization.

RESULTS: Non-normalization of postoperative serum CRP level and pathologic T3 stage were identified as independent predictive factors of shorter CSS in univariate and multivariate analysis (p=0.0150 and 0.0037, hazard ratio: 3.628 and 4.470, respectively). We classified the patients into three groups using these factors and found that five-year CSS was 88%, 42.5%, and 0% in the low-risk group (zero factors), intermediate-risk group (one factor), and high-risk group (two factors), respectively (p<0.0001).

CONCLUSIONS: Non-normalization of postoperative serum CRP level and pathologic T stage were identified as independent postoperative prognostic factors in patients with UTUC who underwent RNU. These factors can stratify three prognostic groups and may help urologists in clinical decision-making for adjuvant therapy.

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Published

2023-11-23

How to Cite

Teishima, J., Hirata, J., Toge, T., Uematsu, R., Mita, Y., Yoshii, T., & Nakamura, I. (2023). Prognostic model using postoperative normalization of C-reactive protein levels in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy. Canadian Urological Association Journal, 18(3), E84–90. https://doi.org/10.5489/cuaj.8393

Issue

Vol. 18 No. 3 (2024): CUAJ March

Section

Original Research

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