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Medical Oncology

, 37:9 | Cite as

Prognostic impact of C-reactive protein-albumin ratio for the lethality in castration-resistant prostate cancer

  • Taizo Uchimoto
  • Kazumasa KomuraEmail author
  • Yuya Fujiwara
  • Kenkichi Saito
  • Naoki Tanda
  • Tomohisa Matsunaga
  • Atsushi Ichihashi
  • Takeshi Tsutsumi
  • Takuya Tsujino
  • Yuki Yoshikawa
  • Yudai Nishimoto
  • Tomoaki Takai
  • Koichiro Minami
  • Kohei Taniguchi
  • Tomohito Tanaka
  • Hirofumi Uehara
  • Hajime Hirano
  • Hayahito Nomi
  • Naokazu Ibuki
  • Kiyoshi Takahara
  • Teruo Inamoto
  • Haruhito Azuma
Original Paper

Abstract

This study aimed to assess the clinical value of C-reactive protein-albumin ratio (CAR) at the initiation of first-line treatment for castration-resistant prostate cancer (CRPC). We identified 221 CRPC patients treated with either androgen-signaling inhibitors (ASIs: abiraterone and enzalutamide) or docetaxel as the first-line treatment. The value of CAR was evaluated at the initiation of first-line treatment. The optimal cutoff value of CAR for the prediction of lethality was defined by the receiver operating characteristic curve and the Youden Index. The primary endpoints of the study included overall survival (OS) and cancer-specific survival (CSS). The median age was 74 years. The optimal cutoff value of CAR in newly diagnosed CRPC patients was 0.5 (CAR > 0.5: n = 77 and CAR ≤ 0.5: n = 144). The 3-year OS and CSS rate in patients with CAR > 0.5 were significantly lower than those with CAR ≤ 0.5 (OS: 30.9% vs 55.5%, p < 0.001) (CSS: 42.5% vs 65.4%, p < 0.001). A multivariate analysis consistently demonstrated that CAR was an independent predictor for both OS and CSS. When stratified by the first-line treatments, patients with CAR > 0.5 has significantly shorter CSS than those with CAR ≤ 0.5 in abiraterone (median of 23 vs 49 months, p < 0.001) and enzalutamide (median of 23 vs 41 months, p = 0.0016), whereas no difference was observed in patients treated with docetaxel as the first-line treatment (median of 34 and 37 months, p = 0.7708). Despite the limited cohort size and retrospective design, increased CAR seemed to serve as an independent predictor of OS and CSS for patients newly diagnosed with CRPC.

Keywords

Castration-resistant prostate cancer Abiraterone Enzalutamide Docetaxcel C-reactive protein-albumin ratio 

Notes

Funding

This work was partially supported by Grant-in-Aid No. 19K18624 (Japan Society for the Promotion of Science: JSPS), the Uehara Memorial Foundation, the NOVARTIS Foundation (Japan) for the Promotion of Science, Japan Research Foundation for Clinical Pharmacology, Yamaguchi Endocrine Disease Research Foundation, and the Takeda Science Foundation 2018 in Japan.

Compliance with ethical standards

Conflict of interest

All authors declared that they have no conflict of interest.

Ethical approval

The study design was approved in the institutional review board of Osaka Medical College (IRB Approval Number: RIN-750-2571).

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Taizo Uchimoto
    • 1
    • 2
  • Kazumasa Komura
    • 1
    • 3
    Email author
  • Yuya Fujiwara
    • 1
  • Kenkichi Saito
    • 1
  • Naoki Tanda
    • 1
  • Tomohisa Matsunaga
    • 4
  • Atsushi Ichihashi
    • 5
  • Takeshi Tsutsumi
    • 1
  • Takuya Tsujino
    • 6
  • Yuki Yoshikawa
    • 1
  • Yudai Nishimoto
    • 7
  • Tomoaki Takai
    • 6
  • Koichiro Minami
    • 4
  • Kohei Taniguchi
    • 3
  • Tomohito Tanaka
    • 3
  • Hirofumi Uehara
    • 1
  • Hajime Hirano
    • 1
  • Hayahito Nomi
    • 1
  • Naokazu Ibuki
    • 1
  • Kiyoshi Takahara
    • 8
  • Teruo Inamoto
    • 1
  • Haruhito Azuma
    • 1
  1. 1.Department of UrologyOsaka Medical CollegeTakatsuki CityJapan
  2. 2.Department of UrologySaiseikai-Nakatsu HospitalOsaka CityJapan
  3. 3.Translational Research ProgramOsaka Medical CollegeTakatsuki CityJapan
  4. 4.Department of UrologyOsaka Medical College Mishima-Minami HospitalTakatsuki CityJapan
  5. 5.Department of UrologyAijinkai-Takatsuki HospitalTakatsuki CityJapan
  6. 6.Division of Urology, Department of SurgeryBrigham and Women’s HospitalBostonUSA
  7. 7.Department of UrologyHirakata Municipal HospitalHirakata CityJapan
  8. 8.Department of UrologyFujita-Health University School of MedicineToyoake City, NagoyaJapan

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