Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients

Authors: Shengjie Guo, Xiaobo He, Qian Chen, Guangwei Yang, Kai Yao, Pei Dong, Yunlin Ye, Dong Chen, Zhiling Zhang, Zike Qin, Zhuowei Liu, Yunfei Xue, Meng Zhang, Ruiwu Liu, Fangjian Zhou, Hui Han

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

The preoperative C-reactive protein/Albumin (CRP/Alb) ratio has been shown to be valuable in predicting the prognosis of patients with certain cancers. The aim of our study is to explore its prognostic value in patients with renal cell carcinoma (RCC).

Methods

A retrospective study was performed in 570 RCC patients underwent radical or partial nephrectomy including 541 patients who received full resection of localized (T1-3 N0/+ M0) RCC. The optimal cutoff value of CRP/Alb was determined by the receive operating characteristic (ROC) analysis. The impact of the CRP/Alb and other clinicopathological characteristics on overall survival (OS) and disease-free survival (DFS) was evaluated using the univariate and multivariate Cox regression analysis.

Results

The optimal cutoff of CRP/Alb ratio was set at 0.08 according to the ROC analysis. Multivariate analysis indicated that CRP/Alb ratio was independently associated with OS of RCC patients underwent radical or partial nephrectomy (hazard ratio [HR]: 1.94; 95% confidence interval [95% CI]: 1.12–3.36; P = 0.018), and DFS of localized RCC patients underwent full resection (HR: 2.14; 95% CI: 1.22–3.75; P = 0.008).

Conclusion

Elevated CRP/Alb ratio was an independent prognostic indicator for poor OS in patients underwent radical or partial nephrectomy and DFS of localized RCC patients underwent full resection. Overall, CRP/Alb may help to identify patients with high relapse risk.
Appendix
Available only for authorised users
Literature
1.
2.
Palsdottir HB, Hardarson S, Petursdottir V, Jonsson A, Jonsson E, Sigurdsson MI, Einarsson GV, Gudbjartsson T. Incidental detection of renal cell carcinoma is an independent prognostic marker: results of a long-term, whole population study. J Urol. 2012;187(1):48–53.CrossRefPubMed
3.
Park YH, Baik KD, Lee YJ, Ku JH, Kim HH, Kwak C. Late recurrence of renal cell carcinoma >5 years after surgery: clinicopathological characteristics and prognosis. BJU Int. 2012;110(11 Pt B):E553–8.CrossRefPubMed
4.
Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, Kuczyk MA, Lam T, Marconi L, Merseburger AS, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015;67(5):913–24.CrossRefPubMed
5.
Battaglia M, Lucarelli G. The role of renal surgery in the era of targeted therapy: the urologist’s perspective. Urologia. 2015;82(3):137–8.CrossRefPubMed
6.
Lee-Ying R, Lester R, Heng D. Current management and future perspectives of metastatic renal cell carcinoma. Int J Urol. 2014;21(9):847–55.CrossRefPubMed
7.
Billia M, Volpe A, Terrone C. The current TNM staging system of renal cell carcinoma: are further improvements needed? Arch Esp Urol. 2011;64(10):929–37.PubMed
8.
Hayes DF, Allen J, Compton C, Gustavsen G, Leonard DG, McCormack R, Newcomer L, Pothier K, Ransohoff D, Schilsky RL, et al. Breaking a vicious cycle. Sci Transl Med. 2013;5(196):196c.CrossRef
9.
Tai CG, Johnson TV, Abbasi A, Herrell L, Harris WB, Kucuk O, Canter DJ, Ogan K, Pattaras JG, Nieh PT, et al. External validation of the modified Glasgow prognostic score for renal cancer. Indian J Urol. 2014;30(1):33–7.CrossRefPubMedPubMedCentral
10.
Mathias TM, Silva JF, Sapata VM, Marson FC, Zanoni JN, Silva CO. Evaluation of the effects of periodontal treatment on levels of ascorbic acid in smokers. J Int Acad Periodontol. 2014;16(4):109–14.PubMed
11.
Gunduz S, Mutlu H, Tural D, Yildiz O, Uysal M, Coskun HS, Bozcuk H. Platelet to lymphocyte ratio as a new prognostic for patients with metastatic renal cell cancer. Asia Pac J Clin Oncol. 2015;11(4):288–92.CrossRefPubMed
12.
Yang JJ, Hu ZG, Shi WX, Deng T, He SQ, Yuan SG. Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: a meta-analysis. World J Gastroenterol. 2015;21(9):2807–15.CrossRefPubMedPubMedCentral
13.
Omae K, Kondo T, Tanabe K. High preoperative C-reactive protein values predict poor survival in patients on chronic hemodialysis undergoing nephrectomy for renal cancer. Urol Oncol. 2015;33(2):67–9.CrossRefPubMed
14.
Morgan TM, Tang D, Stratton KL, Barocas DA, Anderson CB, Gregg JR, Chang SS, Cookson MS, Herrell SD, Smith JJ, et al. Preoperative nutritional status is an important predictor of survival in patients undergoing surgery for renal cell carcinoma. Eur Urol. 2011;59(6):923–8.CrossRefPubMedPubMedCentral
15.
Choi Y, Park B, Jeong BC, Seo SI, Jeon SS, Choi HY, Adami HO, Lee JE, Lee HM. Body mass index and survival in patients with renal cell carcinoma: a clinical-based cohort and meta-analysis. Int J Cancer. 2013;132(3):625–34.CrossRefPubMed
16.
Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M, Tanaka K, Fushiya N, Koike K, Nishino H, Matsushima M. The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma. Ann Surg Oncol. 2015;22(3):803–10.CrossRefPubMed
17.
Liu X, Sun X, Liu J, Kong P, Chen S, Zhan Y, Xu D. Preoperative C-reactive protein/albumin ratio predicts prognosis of patients after curative resection for gastric cancer. Transl Oncol. 2015;8(4):339–45.CrossRefPubMedPubMedCentral
18.
Zhou T, Zhan J, Hong S, Hu Z, Fang W, Qin T, Ma Y, Yang Y, He X, Zhao Y, et al. Ratio of C-reactive protein/albumin is an inflammatory prognostic score for predicting overall survival of patients with small-cell lung cancer. Sci Rep. 2015;5:10481.CrossRefPubMedPubMedCentral
19.
Chen Z, Shao Y, Fan M, Zhuang Q, Wang K, Cao W, Xu X, He X. Prognostic significance of preoperative C-reactive protein: albumin ratio in patients with clear cell renal cell carcinoma. Int J Clin Exp Pathol. 2015;8(11):14893–900.PubMedPubMedCentral
20.
Brull DJ, Serrano N, Zito F, Jones L, Montgomery HE, Rumley A, Sharma P, Lowe GD, World MJ, Humphries SE, et al. Human CRP gene polymorphism influences CRP levels: implications for the prediction and pathogenesis of coronary heart disease. Arterioscler Thromb Vasc Biol. 2003;23(11):2063–9.CrossRefPubMed
21.
Greenfield JR, Samaras K, Jenkins AB, Kelly PJ, Spector TD, Gallimore JR, Pepys MB, Campbell LV. Obesity is an important determinant of baseline serum C-reactive protein concentration in monozygotic twins, independent of genetic influences. Circulation. 2004;109(24):3022–8.CrossRefPubMed
22.
23.
Deichmann M, Benner A, Waldmann V, Bock M, Jackel A, Naher H. Interleukin-6 and its surrogate C-reactive protein are useful serum markers for monitoring metastasized malignant melanoma. J Exp Clin Cancer Res. 2000;19(3):301–7.PubMed
24.
Nozoe T, Korenaga D, Futatsugi M, Saeki H, Maehara Y, Sugimachi K. Immunohistochemical expression of C-reactive protein in squamous cell carcinoma of the esophagus - significance as a tumor marker. CANCER LETT. 2003;192(1):89–95.CrossRefPubMed
25.
Wieland A, Kerbl R, Berghold A, Schwinger W, Mann G, Urban C. C-reactive protein (CRP) as tumor marker in pediatric and adolescent patients with Hodgkin disease. Med Pediatr Oncol. 2003;41(1):21–5.CrossRefPubMed
26.
Mroczko B, Groblewska M, Gryko M, Kedra B, Szmitkowski M. Diagnostic usefulness of serum interleukin 6 (IL-6) and C-reactive protein (CRP) in the differentiation between pancreatic cancer and chronic pancreatitis. J Clin Lab Anal. 2010;24(4):256–61.CrossRefPubMed
27.
Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357(9255):539–45.CrossRefPubMed
28.
29.
Jabs WJ, Busse M, Kruger S, Jocham D, Steinhoff J, Doehn C. Expression of C-reactive protein by renal cell carcinomas and unaffected surrounding renal tissue. Kidney Int. 2005;68(5):2103–10.CrossRefPubMed
30.
Sim SH, Messenger MP, Gregory WM, Wind TC, Vasudev NS, Cartledge J, Thompson D, Selby PJ, Banks RE. Prognostic utility of pre-operative circulating osteopontin, carbonic anhydrase IX and CRP in renal cell carcinoma. Br J Cancer. 2012;107(7):1131–7.CrossRefPubMedPubMedCentral
31.
Steffens S, Kohler A, Rudolph R, Eggers H, Seidel C, Janssen M, Wegener G, Schrader M, Kuczyk MA, Schrader AJ. Validation of CRP as prognostic marker for renal cell carcinoma in a large series of patients. BMC Cancer. 2012;12:399.CrossRefPubMedPubMedCentral
32.
Yasuda Y, Saito K, Yuasa T, Kitsukawa S, Urakami S, Yamamoto S, Yonese J, Takahashi S, Fukui I. Prognostic impact of pretreatment C-reactive protein for patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors. Int J Clin Oncol. 2013;18(5):884–9.CrossRefPubMed
33.
Fujita T, Nishi M, Tabata K, Matsumoto K, Yoshida K, Iwamura M. Overall prognostic impact of C-reactive protein level in patients with metastatic renal cell carcinoma treated with sorafenib. Anticancer Drugs. 2016;27(10):1028–32.CrossRefPubMed
34.
Baker JP, Detsky AS, Wesson DE, Wolman SL, Stewart S, Whitewell J, Langer B, Jeejeebhoy KN. Nutritional assessment: a comparison of clinical judgement and objective measurements. N Engl J Med. 1982;306(16):969–72.CrossRefPubMed
35.
Rohlman DS, Bailey SR, Anger WK, McCauley L. Assessment of neurobehavioral function with computerized tests in a population of hispanic adolescents working in agriculture. Environ Res. 2001;85(1):14–24.CrossRefPubMed
36.
Kim HL, Han KR, Zisman A, Figlin RA, Belldegrun AS. Cachexia-like symptoms predict a worse prognosis in localized t1 renal cell carcinoma. J Urol. 2004;171(5):1810–3.CrossRefPubMed
37.
Kim HL, Belldegrun AS, Freitas DG, Bui MH, Han KR, Dorey FJ, Figlin RA. Paraneoplastic signs and symptoms of renal cell carcinoma: implications for prognosis. J Urol. 2003;170(5):1742–6.CrossRefPubMed
Metadata
Title
The C-reactive protein/albumin ratio, a validated prognostic score, predicts outcome of surgical renal cell carcinoma patients
Authors
Shengjie Guo
Xiaobo He
Qian Chen
Guangwei Yang
Kai Yao
Pei Dong
Yunlin Ye
Dong Chen
Zhiling Zhang
Zike Qin
Zhuowei Liu
Yunfei Xue
Meng Zhang
Ruiwu Liu
Fangjian Zhou
Hui Han
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3119-6

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue

Research article

Can you un-ring the bell? A qualitative study of how affect influences cancer screening decisions

Research article

Quantitation of DNA methylation in Epstein-Barr virus–associated nasopharyngeal carcinoma by bisulfite amplicon sequencing

Study protocol

Internet-based perioperative exercise program in patients with Barrett’s carcinoma scheduled for esophagectomy [iPEP - study] a prospective randomized-controlled trial

Research article

Carbon ion radiotherapy for 80 years or older patients with hepatocellular carcinoma

Research article

Guanylate-binding protein-1 is a potential new therapeutic target for triple-negative breast cancer

Research article

Ethnic differences in colon cancer care in the Netherlands: a nationwide registry-based study
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits