Abstract | PURPOSE: MATERIALS AND METHODS: Testing was performed on 399 patients with stages T(1-4), N(0-2), M(0-1) 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/8x10(9) 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/8x10(9) 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 <0.001). CONCLUSIONS:
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Authors | Pierre Bigot, Giovanni Lughezzani, Pierre Karakiewicz, Paul Perrotte, Nathalie Rioux-Leclercq, Veronique Catros-Quemener, Francoise Bouet, Jean-Philippe Moulinoux, Bernard Cipolla, Jean Jacques Patard |
Journal | The Journal of urology
(J Urol)
Vol. 183
Issue 2
Pg. 486-91
(Feb 2010)
ISSN: 1527-3792 [Electronic] United States |
PMID | 20006872
(Publication Type: Journal Article)
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Copyright | Copyright 2010 American Urological Association. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Renal Cell
(blood, mortality, surgery)
- Female
- Humans
- Kidney Neoplasms
(blood, mortality, surgery)
- Male
- Middle Aged
- Nephrectomy
- Prognosis
- Prospective Studies
- Retrospective Studies
- Spermidine
(blood)
- Spermine
(blood)
- Survival Rate
- Young Adult
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