Korean J Urol.  2011 Feb;52(2):104-109.

Prognostic Significance of Preoperative C-Reactive Protein Elevation and Thrombocytosis in Patients with Non-Metastatic Renal Cell Carcinoma

• Cho DS
• Kim SJ
• Lee SH
• Ahn HS
• Kim YS
• Kim SI

Abstract

PURPOSE
The aim of this study was to investigate the association of preoperative C-reactive protein (CRP) elevation and thrombocytosis with the prognosis of patients with non-metastatic renal cell carcinoma (RCC).
MATERIALS AND METHODS
This was a retrospective review of the medical records of 177 patients (130 men and 47 women) with non-metastatic RCC who underwent a radical nephrectomy between March 2000 and May 2008 and for whom preoperative CRP and platelet data were available for analysis. Preoperative CRP elevation and thrombocytosis were compared with clinical and pathological variables.
RESULTS
There were 38 patients with CRP elevation and 11 patients with thrombocytosis. The mean follow-up time was 48.3 months (median, 48.0; range, 13-111 months). Twenty-three patients (13.0%) developed metastases and six patients died during the follow-up period. CRP elevation was significantly correlated with anemia (p=0.001), T stage (p=0.004), grade (p=0.025), and metastasis (p<0.001). Thrombocytosis was significantly correlated with anemia (p=0.003), T stage (p=0.002), and metastasis (p=0.001). The univariate analysis identified anemia, CRP elevation, thrombocytosis, tumor histology subtype, tumor size, T stage, and grade as significant prognostic factors associated with recurrence-free survival, whereas the multivariate analyses showed that CRP elevation (p=0.033) and tumor size (p=0.007) were independent prognostic factors.
CONCLUSIONS
Preoperative CRP elevation and thrombocytosis were associated with a poorer prognosis and a higher recurrence rate in patients with non-metastatic RCC. Moreover, preoperative CRP elevation appeared to be an independent predictor of tumor recurrence and prognosis. Preoperative thrombocytosis, however, was not an independent prognostic factor for tumor recurrence and prognosis.

Keyword

C-reactive protein; Prognosis; Renal cell carcinoma; Thrombocytosis

MeSH Terms

Anemia
Blood Platelets
C-Reactive Protein
Carcinoma, Renal Cell
Follow-Up Studies
Humans
Male
Medical Records
Multivariate Analysis
Neoplasm Metastasis
Nephrectomy
Prognosis
Recurrence
Retrospective Studies
Thrombocytosis
C-Reactive Protein

Figure

• 

  FIG. 1 Kaplan-Meier recurrence-free survival curves according to C-reactive protein (CRP) level. The survival rate of patients with CRP elevation (CRP≥0.8 mg/dl) was significantly lower than that of patients with a normal CRP level (p<0.001).

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