The Prognostic Value of Erythrocyte Polyamine in the Post-Nephrectomy Stratification of Renal Cell Carcinoma Specific Mortality

Pierre Bigot, Giovanni Lughezzani, Pierre Karakiewicz, Paul Perrotte, Nathalie Rioux-Leclercq, Veronique Catros-Quemener, Francoise Bouet, Jean Philippe Moulinoux, Bernard Cipolla, Jean Jacques Patard

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The polyamines spermine and spermidine are ubiquitous polycationic structures which are essential for cell proliferation and differentiation. Circulating polyamines, spermine and spermidine, represent valuable prognostic markers in prostate cancer, acute leukemia and supratentorial malignant glioma. We tested whether spermine and spermidine could improve the prognostic ability of several established predictors of cancer specific mortality after partial or radical nephrectomy for renal cell carcinoma. Materials and Methods: Testing was performed on 399 patients with stages T1-4, N0-2, M0-1 renal cell carcinoma who were treated with radical or partial nephrectomy at a single institution between 1990 and 2007. Univariable and multivariable Cox regression models tested the prognostic ability of spermine and spermidine levels in cancer specific mortality predictions. Covariates consisted of TNM stage, Fuhrman grade, tumor size and symptom classification. Harrell's concordance index (c-index) quantified accuracy and 200 bootstrap resamples were used to correct for overfit bias. Results: The 5-year cancer specific mortality-free survival of patients with spermine levels 3 or less, 3.1 to 8, 8.1 to 13 and greater than 13 nmol/8×109 erythrocytes was 88.8%, 75.8%, 40.2% and 21.8%, respectively. Similarly the 5-year cancer specific mortality-free survival of patients with spermidine levels 12 or less, 12.1 to 15, 15.1 to 21 and greater than 21 nmol/8×109 erythrocytes was 79.0%, 56.6%, 53.2% and 27.4%, respectively. On multivariable analyses addressing cancer specific mortality after surgery spermine (p = 0.007) and spermidine (p = 0.04) achieved independent predictor status. Consideration of spermine and spermidine also improved the accuracy of established cancer specific mortality predictors by 2.2% (p

Original languageEnglish
Pages (from-to)486-492
Number of pages7
JournalJournal of Urology
Volume183
Issue number2
DOIs
Publication statusPublished - Feb 2010

Keywords

  • carcinoma
  • polyamines
  • renal cell
  • spermidine
  • spermine
  • survival

ASJC Scopus subject areas

  • Urology

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