Journal
BRITISH JOURNAL OF CANCER
Volume 107, Issue 7, Pages 1131-1137Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/bjc.2012.360
Keywords
osteopontin; renal cancer; carbonic anhydrase IX; prognosis; RCC; CRP
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Funding
- NIHR under its Programme Grants for Applied Research Programme [RP-PG-0707-10101]
- Cancer Research UK programme
- National Institute for Health Research [RP-PG-0707-10101, NF-SI-0509-10020] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [RP-PG-0707-10101] Funding Source: National Institutes of Health Research (NIHR)
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BACKGROUND: Objectively measured circulating biomarkers of prognosis complementing existing clinicopathological models are needed in renal cell carcinoma (RCC). METHODS: Blood samples collected from 216 RCC patients in Leeds before nephrectomy (median follow-up 7 years) were analysed for C-reactive protein (CRP), osteopontin (OPN) and carbonic anhydrase IX (CA9) and prognostic significance determined. RESULTS: CA9, OPN and CRP were univariately prognostic for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) with CRP and CA9 being independently prognostic for OS/CSS and OS, respectively. Including CA9, OPN and CRP with other conventional prognostic factors gave a superior predictive capacity when compared with a previously published pre-operative clinical nomogram (Karakiewicz et al, 2009). Osteopontin outperformed this nomogram and the post-operative SSIGN score for OS but not for CSS, being significantly predictive for non-cancer deaths. Osteopontin, CRP and CA9 outperformed stage (c-index 76% compared with 70% for stage) and OPN or CA9 identified several subsets of poor prognosis patients including in T1 patients, who may benefit from adjuvant therapy and increased surveillance. CONCLUSION: Circulating CA9, OPN and CRP add value to existing clinicopathological prognostic factors/models and support further studies to investigate their potential use in improving the clinical management of RCC. British Journal of Cancer (2012) 107, 1131-1137. doi:10.1038/bjc.2012.360 www.bjcancer.com Published online 23 August 2012 (c) 2012 Cancer Research UK
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