Prospective study of the role of inflammation in renal cancer

Urol Int. 2012;88(3):277-81. doi: 10.1159/000334971. Epub 2012 Feb 23.

Abstract

Background: The local and systemic inflammatory responses provide prognostic information in cancer. The modified Glasgow Prognostic Score (mGPS) provides additional prognostic information than C-reactive protein (CRP) alone when assessing the systemic inflammation in cancer. The aim of this study was to determine the role of local and systemic inflammation in renal cancer.

Methods: The cohort consisted of 79 patients who had undergone potential curative resection. Systemic inflammation, mGPS, was constructed by measuring preoperative CRP and albumin concentrations and the Klintrup-Makinen score was evaluated histologically for the local inflammatory response. Pathological parameters such as T stage, grade and tumour necrosis were also assessed. The local inflammatory response was assessed by examining all inflammatory cells at the tumour edge on diagnostic haematoxylin and eosin slides.

Results: On univariate analysis, T stage (p < 0.001), grade (p = 0.044) and mGPS (p < 0.001) were significant predictors of cancer-specific survival. On multivariate analysis, mGPS (hazard ratio 8.64, 95% confidence interval 3.5-21.29, p < 0.001) was the only significant independent predictor of cancer-specific survival.

Conclusion: A preoperative systemic inflammatory response as measured by the mGPS is an independent predictor of poor cancer-specific survival in renal cancer in patients undergoing potential curative resection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / analysis*
  • Carcinoma, Renal Cell / blood
  • Carcinoma, Renal Cell / immunology*
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / surgery
  • Chi-Square Distribution
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / immunology*
  • Inflammation / mortality
  • Inflammation / pathology
  • Inflammation Mediators / blood*
  • Kaplan-Meier Estimate
  • Kidney Neoplasms / blood
  • Kidney Neoplasms / immunology*
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / surgery
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Necrosis
  • Neoplasm Grading
  • Neoplasm Staging
  • Nephrectomy
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Scotland
  • Serum Albumin / analysis*
  • Time Factors
  • Treatment Outcome
  • Up-Regulation

Substances

  • Inflammation Mediators
  • Serum Albumin
  • C-Reactive Protein