Journal
BRITISH JOURNAL OF CANCER
Volume 107, Issue 7, Pages 1031-1036Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/bjc.2012.254
Keywords
C-reactive protein; advanced urothelial carcinoma; biomarker; survival prediction; nomogram; decision curve analysis
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BACKGROUND: The purpose of this study is to investigate the prognostic impact of C-reactive protein (CRP) on patients with advanced urothelial carcinoma and to develop a novel nomogram predicting survival. METHODS: A total of 223 consecutive patients were treated at Tokyo Medical and Dental Hospital. A nomogram incorporating V was developed based on the result of a Cox proportional hazards model. Its efficacy and clinical usefulness was evaluated by concordance index (c-index) and decision curve analysis. RESULTS: Of the 223 patients, 184 (83%) died of cancer. Median follow-up periods of patients who died and those who remained alive were 5 and 11 months, respectively. We developed a novel nomogram incorporating Eastern Cooperative Oncology Group Performance Status, presence of visceral metastasis, haemoglobin and age. The c-index of the nomogram predicting survival probability 6 and 12 months after diagnosis was 0.788 and 0.765, respectively. Decision curve analyses revealed that the novel nomogram incorporating CRP had a superior net benefit than that without CRP for most of the examined probabilities. CONCLUSION: We demonstrated the prognostic impact of CRP that improved the predictive accuracy of a nomogram for survival probability in patients with advanced urothelial carcinoma. British Journal of Cancer (2012) 107, 1031-1036. doi:10.1038/bjc.2012.254 www.bjcancer.com Published online 23 August 2012 (c) 2012 Cancer Research UK
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