High preoperative C reactive protein (CRP) levels are associated with poor survival in hemodialysis patients undergoing nephrectomy for renal cell carcinoma (RCC), new study findings suggest.

Kenji Omae, MD, and colleagues at Tokyo Women’s Medical University examined cancer-specific survival in a group of 315 patients with end-stage renal disease requiring hemodialysis and who had nephrectomy for RCC. Of these patients, 75 (23.8%) had elevated CRP levels prior to surgery, defined as a level above 0.5 mg/dL. The median follow-up was 51 months.

The 5-year cancer-specific survival rate was 69.9% for patients with elevated CRP compared with 95.2% for those with CRP levels of 0.5 mg/dL or less, the investigators reported online ahead of print in Urologic Oncology. In multivariate analysis, preoperative CRP levels independently predicted cancer-specific survival, with an elevated CRP level associated with a significant 3.5 times increased risk of death from cancer.

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“We propose that routine measurement of this widely available and inexpensive biomarker could allow better risk stratification and risk-adjusted follow-up of these patients,” the investigators concluded.