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C-reaktives Protein vor radikaler Zystektomie

Präoperative Bestimmung von CRP

C-reactive protein prior to radical cystectomy

Preoperative determination of CRP

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Zusammenfassung

Hintergrund

Zahlreiche Studienergebnisse deuten darauf hin, dass ein erhöhtes C-reaktives Protein (CRP) mit einer systemischen Tumorlast korreliert. Ziel dieser Studie war es zu evaluieren, ob hohe CRP-Werte vor radikaler Zystektomie mit einem schlechteren Überleben assoziiert sind.

Material und Methoden

In dieser retrospektiven Studie haben wir präoperativ erhobene CRP-Werte von 194 Patienten, die im Zeitraum von 1996–2005 aufgrund eines Urothelkarzinoms radikal zystektomiert wurden, mit dem Überleben korreliert. CRP ≥ 5 mg/l wurde als erhöht definiert.

Ergebnisse

Präoperativ erhöhtes CRP wurden bei 89 (45,9 %) Patienten festgestellt. Diese Patienten zeigten häufiger fortgeschrittene Tumorstadien (pT3–4), vermehrt positive Resektionsränder und waren häufiger von positiven Lymphknoten betroffen. Patienten, die ein normales präoperatives CRP aufwiesen, erhielten zudem tendenziell häufiger anspruchsvollere Harnableitungen. In der multivariaten Analyse konnte ein hoher CRP-Wert als unabhängiger prognostischer Parameter für ein geringeres krankheitsspezifisches Überleben identifiziert werden.

Schlussfolgerung

Unsere Ergebnisse bestätigen Hinweise, die einen erhöhten präoperativen CRP-Wert als prognostischen Indikator für ein reduziertes tumorspezifisches Überleben nach radikaler Zystektomie postulieren.

Abstract

Background

Numerous studies have shown a positive correlation between elevated C-reactive protein (CRP) and systemic spread of malignancies. The goal of the current study was to assess the predictive significance of preoperative CRP in patients undergoing radical cystectomy (RC).

Material and methods

Preoperative CRP values were measured in 194 patients undergoing RC because of urothelial carcinoma between 1996 and 2005. Elevated CRP level was defined as ≥5 mg/l.

Results

Preoperative increased CRP values were detected in 89 (45.9%) patients and these patients were more likely to have advanced tumor stages (pT3-4), positive resection margins and positive lymph nodes. Advanced urinary diversions were more common in patients with normal CRP values. In multivariate analysis, CRP was identified as an independent prognostic indicator for poor cancer-specific survival.

Conclusion

The results confirm previous reports that showed a prognostic significance of preoperative CRP elevation.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M.W. Kramer, A. Heinisch, G. Wegener, M. Abbas, C. von Klot, I. Peters, H. Tezval, T.R. Herrmann, M.A. Kuczyk und A.S. Merseburger geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Urologie und Urologische Onkologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    M.W. Kramer, A. Heinisch, C. von Klot, I. Peters, H. Tezval, T.R. Herrmann, M.A. Kuczyk &  A.S. Merseburger

  2. Tumorzentrum, Medizinische Hochschule Hannover, Hannover, Deutschland

    G. Wegener

  3. Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland

    M. Abbas

Authors
  1. M.W. Kramer
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  2. A. Heinisch
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  3. G. Wegener
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  4. M. Abbas
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  5. C. von Klot
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  6. I. Peters
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  7. H. Tezval
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  8. T.R. Herrmann
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  9. M.A. Kuczyk
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  10. A.S. Merseburger
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Corresponding author

Correspondence to A.S. Merseburger.

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Kramer, M., Heinisch, A., Wegener, G. et al. C-reaktives Protein vor radikaler Zystektomie. Urologe 53, 222–227 (2014). https://doi.org/10.1007/s00120-013-3299-x

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  • DOI: https://doi.org/10.1007/s00120-013-3299-x

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