Prognostic significance of inflammation-based prognostic scoring in patients with upper urinary tract urothelial carcinoma

Vol. 45 (3): 541-548, May – June, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0251


ORIGINAL ARTICLE

Taisuke Suyama 1, Shigeki Kanbe 2, Masanobu Maegawa 1, Hirofumi Shimizu 1, Koichi Nakajima 2
1 Department of Genitourinary, Sanaikai General Hospital (IMS), Japan; 2 Department of Genitourinary, Toho University Omori Medical Center, Japan

ABSTRACT

Objectives: To investigate whether Glasgow Prognostic Score has prognostic significance in patients with upper urinary urothelial carcinoma.
Patients and methods: We retrospectively reviewed the clinical records of 74 patients with upper urinary urothelial carcinoma. We set the cut-off value for C-reactive protein as 1.0mg/dL, and 3.5mg/dL for albumin as Glasgow Prognostic Score. Their blood data including albumin and C-reactive protein for Glasgow Prognostic Score and cytokeratin 19 fragment 21-1 as a tumor marker were measured before starting treatment.
The patients were stratifi ed into three groups with Glasgow Prognostic Score: The Group-1, albumin ≥3.5g/dL and C-reactive protein < 1.0mg/dL; Group-2, albumin < 3.5g/dL or C-reactive protein ≥1.0mg/dL; Group-3, albumin < 3.5g/dL and C-reactive protein ≥1.0mg/dL.
Results: The median follow-up for all patients was 26.9 months (range: 10.9-91.1 months), during which 37 (50%) patients died. There was a signifi cant difference in the estimated survival rate among the 3 groups stratifi ed by Glasgow Prognostic Score.
The estimated survival rate in the Group-1 was signifi cantly higher than those in Groups 2 and 3.
In the univariate analysis C-reactive protein, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were signifi cant predictors of overall survival. On the multivariate analysis, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were independently associated with shorter overall survival.
Conclusion: Our review suggests Glasgow Prognostic Score may play as a prognostic predictor for upper urinary urothelial carcinoma.

Keywords: C-Reactive Protein; Keratin-19; Biomarkers; Urinary Tract

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