The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer

Lamb, Gavin W.A., McArdle, Peter A., Ramsey, Sara, McNicol, Anne-Marie, Edwards, Joanne, Aitchison, Michael and McMillan, Donald C. (2008) The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer. BJU International, 102 6: 756-761. doi:10.1111/j.1464-410X.2008.07666.x


Author Lamb, Gavin W.A.
McArdle, Peter A.
Ramsey, Sara
McNicol, Anne-Marie
Edwards, Joanne
Aitchison, Michael
McMillan, Donald C.
Title The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer
Journal name BJU International   Check publisher's open access policy
ISSN 1464-4096
1464-410X
Publication date 2008-09-01
Sub-type Article (original research)
DOI 10.1111/j.1464-410X.2008.07666.x
Volume 102
Issue 6
Start page 756
End page 761
Total pages 6
Place of publication London, United Kingdom
Publisher Wiley- Blackwell
Language eng
Subject 1103 Clinical Sciences
Formatted abstract
 ABSTRACT

To examine the relationship between the systemic inflammatory response (C-reactive protein, CRP), tumour interleukin-6 receptor and cyclooxygenase (COX)-2 expression, tumour T-lymphocytic (CD4+, CD8+) infiltration and cancer survival in patients undergoing resection for renal cell carcinoma (RCC), as both the local and systemic inflammatory responses appear to predict the outcome in these patients.

PATIENTS AND METHODS
The study included 60 patients undergoing nephrectomy for localized RCC. Pre-operative circulating CRP levels were measured and tumour interleukin-6 receptor and COX-2 expression, tumour CD4+ and CD8+ T lymphocytes were assessed using immunohistochemical analysis.

RESULTS
The median follow-up was 78 months, with 14 patients relapsing from their disease and nine cancer-specific deaths. On univariate and multivariate survival analysis, tumour stage and grade and CRP levels were identified as significant factors associated with relapse-free and cancer-specific survival. There was a significant direct relationship between Fuhrman grade and CD4+ T-lymphocytic infiltrate (P < 0.05). An increase in tumour expression of interleukin-6 receptor was weakly associated with an increase in tumour CD8+ T-lymphocytic infiltration (P = 0.057). An increase in tumour CD4+ T-lymphocytic infiltration was associated with an increase in CD8+ T-lymphocytic infiltration (P < 0.01).

CONCLUSIONS
The present results suggest that tumour-based factors such as interleukin-6 receptor and COX-2 expression or T-lymphocytic subset infiltration are subordinate to systemic factors such as CRP level in determining survival in patients with localized RCC.
Keyword Renal cancer
Nephrectomy
Tumour stage
Grade
Performance status
Systemic inflammatory response
Cancer-specific survival
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Mon, 18 Jan 2010, 19:18:52 EST by Christine Ouslinis on behalf of School of Medicine