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Prognostic model using postoperative normalization of C-reactive protein levels in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy.
Teishima, Jun; Hirata, Junichiro; Toge, Takuya; Uematsu, Riku; Mita, Yoshie; Yoshii, Takahiko; Nakamura, Ichiro.
Afiliación
  • Teishima J; Department of Urology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan.
  • Hirata J; Department of Urology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan.
  • Toge T; Department of Urology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan.
  • Uematsu R; Department of Urology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan.
  • Mita Y; Department of Urology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan.
  • Yoshii T; Department of Urology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan.
  • Nakamura I; Department of Urology, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Japan.
Can Urol Assoc J ; 18(3): E84-E90, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38507711
ABSTRACT

INTRODUCTION:

To improve the prediction of outcomes in patients who will undergo radical nephroureterectomy (RN U) 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.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Can Urol Assoc J Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Canadá

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Can Urol Assoc J Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Canadá