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  • Markers of systemic inflammation predict survival in patients with advanced renal cell cancer.

Markers of systemic inflammation predict survival in patients with advanced renal cell cancer.

British journal of cancer (2013-06-20)
P Fox, M Hudson, C Brown, S Lord, V Gebski, P De Souza, C K Lee
ABSTRACT

The host inflammatory response has a vital role in carcinogenesis and tumour progression. We examined the prognostic value of inflammatory markers (albumin, white-cell count and its components, and platelets) in pre-treated patients with advanced renal cell carcinoma (RCC). Using data from a randomised trial, multivariable proportional hazards models were generated to examine the impact of inflammatory markers and established prognostic factors (performance status, calcium, and haemoglobin) on overall survival (OS). We evaluated a new prognostic classification incorporating additional information from inflammatory markers. Of the 416 patients, 362 were included in the analysis. Elevated neutrophil counts, elevated platelet counts, and a high neutrophil-lymphocyte ratio were significant independent predictors for shorter OS in a model with established prognostic factors. The addition of inflammatory markers improves the discriminatory value of the prognostic classification as compared with established factors alone (C-statistic 0.673 vs 0.654, P=0.002 for the difference), with 25.8% (P=0.004) of patients more appropriately classified using the new classification. Markers of systemic inflammation contribute significantly to prognostic classification in addition to established factors for pre-treated patients with advanced RCC. Upon validation of these data in independent studies, stratification of patients using these markers in future clinical trials is recommended.

MATERIALS
Product Number
Brand
Product Description

Tamoxifen citrate for performance test, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Tamoxifen citrate salt, ≥99%
Tamoxifen citrate, European Pharmacopoeia (EP) Reference Standard