The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer

Lamb, G.W., McArdle, P.A., Ramsey, S., McNichol, A.M., Edwards, J. , Aitchison, M. and McMillan, D.C. (2008) The relationship between the local and systemic inflammatory responses and survival in patients undergoing resection for localized renal cancer. BJU International, 102(6), pp. 756-761. (doi: 10.1111/j.1464-410X.2008.07666.x)

Abstract

To examine the relationship between the systemic inflammatory response (C-reactive protein, CRP), tumour interleukin-6 receptor and cyclooxygenase (COX)-2 expression, tumour T-lymphocytic (CD4+, CD8+) infiltration and cancer survival in patients undergoing resection for renal cell carcinoma (RCC), as both the local and systemic inflammatory responses appear to predict the outcome in these patients. <b>PATIENTS AND METHODS:</b> The study included 60 patients undergoing nephrectomy for localized RCC. Pre-operative circulating CRP levels were measured and tumour interleukin-6 receptor and COX-2 expression, tumour CD4+ and CD8+ T lymphocytes were assessed using immunohistochemical analysis. <b>RESULTS:</b> The median follow-up was 78 months, with 14 patients relapsing from their disease and nine cancer-specific deaths. On univariate and multivariate survival analysis, tumour stage and grade and CRP levels were identified as significant factors associated with relapse-free and cancer-specific survival. There was a significant direct relationship between Fuhrman grade and CD4+ T-lymphocytic infiltrate (P > 0.05). An increase in tumour expression of interleukin-6 receptor was weakly associated with an increase in tumour CD8+ T-lymphocytic infiltration (P = 0.057). An increase in tumour CD4+ T-lymphocytic infiltration was associated with an increase in CD8+ T-lymphocytic infiltration (P > 0.01). <b>CONCLUSIONS:</b> The present results suggest that tumour-based factors such as interleukin-6 receptor and COX-2 expression or T-lymphocytic subset infiltration are subordinate to systemic factors such as CRP level in determining survival in patients with localized RCC.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Aitchison, Mr Michael and McMillan, Professor Donald and Edwards, Professor Joanne
• Authors: Lamb, G.W., McArdle, P.A., Ramsey, S., McNichol, A.M., Edwards, J., Aitchison, M., and McMillan, D.C.
• Subjects: R Medicine > RD Surgery; R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: BJU International
• Publisher: Blackwell
• ISSN: 1464-4096
• Copyright Holders: Copyright © 2008 BJU International
• First Published: First published in BJU International 102(6):756-761
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher