TY - JOUR
T1 - The prognostic value of erythrocyte polyamines in the preoperative evaluation of patients with renal cell carcinoma
AU - Lughezzani, Giovanni
AU - Karakiewicz, Pierre I.
AU - Bigot, Pierre
AU - Perrotte, Paul
AU - Crépel, Maxime
AU - Rioux-Leclercq, Nathalie
AU - Catros-Quemener, Véronique
AU - Moulinoux, Jean Philippe
AU - Bouet, Françoise
AU - Cipolla, Bernard
AU - Patard, Jean Jacques
PY - 2010/7
Y1 - 2010/7
N2 - Introduction: Polyamines, spermine and spermidine, are ubiquitous polycationic structures, which are essential for cell proliferation and differentiation. We tested whether spermine and spermidine could improve the prognostic ability of six established preoperative predictors of cancer-specific mortality (CSM) after partial or radical nephrectomy for renal cell carcinoma (RCC). Materials and methods: Overall, 385 patients with clinical stages T1-3, M0-1 RCC were treated with radical or partial nephrectomy at a single institution between 1990 and 2007. Kaplan-Meier plots depicted CSM after stratification according to spermine and spermidine levels (dichotomised to above and below the median value). Univariable and multivariable Cox regression models tested the prognostic ability of continuously coded spermine and spermidine levels in preoperative CSM predictions. Covariates consisted of pre-treatment T stage, M stage, age, gender and symptom classification. Results: The 5-year CSM-free survival of patients with spermine levels ≤4.5 and >4.5 nmol/8 × 109 erythrocytes were, respectively, 79.5% and 65.0%. Similarly, the 5-year CSM-free survival of patients with spermidine levels ≤9.0 and > 9.0 nmol/8 × 109 erythrocytes were, respectively, 81.1% and 63.7%. In multivariable analyses addressing CSM after surgery, both spermine (p ≤ 0.002) and spermidine (p ≤ 0.001) achieved independent predictor status and improved the accuracy of established preoperative CSM predictors by 2.1% (p <0.001). Conclusions: Circulating polyamine levels may significantly improve the prognostic value of established determinants of CSM in patients with RCC of all stages prior to nephrectomy. External validation of our findings is required prior to implementation in clinical practice. Crown
AB - Introduction: Polyamines, spermine and spermidine, are ubiquitous polycationic structures, which are essential for cell proliferation and differentiation. We tested whether spermine and spermidine could improve the prognostic ability of six established preoperative predictors of cancer-specific mortality (CSM) after partial or radical nephrectomy for renal cell carcinoma (RCC). Materials and methods: Overall, 385 patients with clinical stages T1-3, M0-1 RCC were treated with radical or partial nephrectomy at a single institution between 1990 and 2007. Kaplan-Meier plots depicted CSM after stratification according to spermine and spermidine levels (dichotomised to above and below the median value). Univariable and multivariable Cox regression models tested the prognostic ability of continuously coded spermine and spermidine levels in preoperative CSM predictions. Covariates consisted of pre-treatment T stage, M stage, age, gender and symptom classification. Results: The 5-year CSM-free survival of patients with spermine levels ≤4.5 and >4.5 nmol/8 × 109 erythrocytes were, respectively, 79.5% and 65.0%. Similarly, the 5-year CSM-free survival of patients with spermidine levels ≤9.0 and > 9.0 nmol/8 × 109 erythrocytes were, respectively, 81.1% and 63.7%. In multivariable analyses addressing CSM after surgery, both spermine (p ≤ 0.002) and spermidine (p ≤ 0.001) achieved independent predictor status and improved the accuracy of established preoperative CSM predictors by 2.1% (p <0.001). Conclusions: Circulating polyamine levels may significantly improve the prognostic value of established determinants of CSM in patients with RCC of all stages prior to nephrectomy. External validation of our findings is required prior to implementation in clinical practice. Crown
KW - Circulating polyamines
KW - Nephrectomy
KW - Renal cell carcinoma
KW - Spermidine
KW - Spermine
KW - Survival
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U2 - 10.1016/j.ejca.2010.02.052
DO - 10.1016/j.ejca.2010.02.052
M3 - Article
C2 - 20335019
AN - SCOPUS:77953293140
VL - 46
SP - 1927
EP - 1935
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 10
ER -