Medical Oncology

, 31:841 | Cite as

Prognostic significance of serum albumin in patients with metastatic renal cell carcinoma

Original Paper
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Accepted:

Abstract

Systemic inflammation has been suggested to impact on the prognosis of metastatic renal cell carcinoma (mRCC). We undertook a retrospective analysis of patients with mRCC treated at Akademiska University Hospital in Sweden during the years 2005–2012 to assess the possible prognostic significance of inflammation-related factors including serum albumin, platelet count, weight loss and C-reactive protein (CRP). The Memorial Sloan-Kettering Cancer Center (MSKCC) criteria for prognosis of mRCC and ECOG performance status were assessed for all patients. Overall survival (OS) and progression-free survival (PFS) were calculated according to Kaplan–Meier, and Cox proportional hazards regression was used for uni- and multivariate analyses. The median OS of all patients (n = 84) was 20 months. Univariate analysis identified low serum albumin (HR = 4.17, p < 0.001), elevated platelet count (HR = 2.98, p < 0.001) and patient-reported weight loss prior to diagnosis of mRCC (HR = 2.73, p < 0.001), in addition to MSKCC (HR = 3.35, p = 0.0088) to be associated with shorter OS. CRP did not significantly affect OS. Serum albumin retained prognostic significance for OS in multivariate analysis (HR = 2.72, p = 0.015). In patients treated with an angiogenesis-targeted agent (n = 47), low serum albumin level (HR = 4.63, p < 0.001) and elevated platelet count (HR = 2.11, p = 0.022) were associated with shorter PFS. In contrast, CRP, weight loss and MSKCC risk group did not significantly affect PFS. In multivariate analysis serum albumin remained associated with PFS (HR = 3.92, p = 0.0035). Our findings identify serum albumin as an independent prognostic factor for patients with mRCC treated with angiogenesis-targeted therapy.

Keywords

Renal cell carcinoma Albumin Prognostic factor Metastatic Weight loss Inflammation 
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Notes

Acknowledgments

Supported by The Research Foundation of the Department of Oncology at Uppsala University. We are grateful to Jonas Selling for statistical expertise.

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Maria Stenman
    • 1
    • 3
  • Anna Laurell
    • 1
  • Magnus Lindskog
    • 1
    • 2
  1. 1.Unit of Oncology, Department of Radiology, Oncology and Radiation ScienceUppsala UniversityUppsalaSweden
  2. 2.Department of Oncology and PathologyKarolinska InstitutetStockholmSweden
  3. 3.Department of OncologyUppsala University HospitalUppsalaSweden

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