Serum immunosuppressive acidic protein doubling time as a prognostic factor for recurrent renal cell carcinoma after nephrectomy

Araki, Kazuhiro; Igarashi, Tatsuo; Tobe, Toyofusa; Mizoguchi, Kenichi; Suzuki, Hiroyoshi; Furuya, Yuzo; Ichikawa, Tomohiko; Nakatsu, Hiro-Omi; Ito, Haruo

doi:10.1016/j.urology.2006.08.1071

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Volume 68, Issue 6 , Pages 1178-1182, December 2006

Serum immunosuppressive acidic protein doubling time as a prognostic factor for recurrent renal cell carcinoma after nephrectomy

Kazuhiro Araki
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
- Reprint requests: Kazuhiro Araki, M.D., Department of Urology, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8670 Japan.
Tatsuo Igarashi
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
- Research Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
Toyofusa Tobe
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
Kenichi Mizoguchi
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
Hiroyoshi Suzuki
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
Yuzo Furuya
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
Tomohiko Ichikawa
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan
Hiro-Omi Nakatsu
- Department of Urology, Asahi General Hospital, Chiba, Japan
Haruo Ito
- Department of Urology, Chiba University Graduate School of Medicine, Chiba, Japan

Received 16 October 2005; accepted 14 August 2006. published online 04 December 2006.

Abstract

Objectives

To identify the prognostic factors in patients with recurrent renal cell carcinoma after nephrectomy, various factors were assessed, with special attention to serum immunosuppressive acidic protein (IAP) and its doubling time.

Methods

Age, sex, stage, grade, histopathologic type, primary tumor size, site and number of metastatic organs, time to recurrence, IAP levels before nephrectomy and at the diagnosis of recurrence, and IAP doubling time just before recurrence were analyzed in 125 patients with recurrent renal cell carcinoma after nephrectomy.

Results

Univariate analysis identified stage, grade, histopathologic type, primary tumor size, time to recurrence, IAP level at the diagnosis of recurrence, and IAP doubling time as significant prognostic factors. After exclusion of confounding factors, multivariate analysis showed that IAP doubling time was the most potent independent prognostic factor. Patient survival rates dichotomized according to IAP doubling time were compared at 100-day intervals from 100 to 700 days and 1000 and 2000 days. The maximal difference in survival rate was found when the cutoff level in the IAP doubling time was set at 200 days.

Conclusions

The results of our study have shown that the IAP doubling time is a potent prognostic factor in patients with recurrent renal cell carcinoma. Periodic checkups with serum IAP level monitoring are recommended to predict prognosis after recurrence.