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Preoperative Plasma Insulin-Like Growth Factor-I and Its Binding Proteins-Based Risk Stratification of Patients Treated With Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma
M. Kardoust Parizi, M. Rouprêt, N. Singla, JY. Teoh, P. Chlosta, M. Babjuk, M. Abufaraj, V. Margulis, D. D'Andrea, J. Klemm, A. Matsukawa, E. Laukhtina, T. Fazekas, PI. Karakiewicz, R. Bhanvadia, P. Gontero, SF. Shariat
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- hodnocení rizik metody MeSH
- IGFBP-3 krev MeSH
- insulinu podobný růstový faktor I * metabolismus MeSH
- karcinom z přechodných buněk chirurgie krev patologie mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádorové biomarkery krev MeSH
- nefroureterektomie * metody MeSH
- peptidy podobné insulinu MeSH
- předoperační období MeSH
- prognóza MeSH
- protein 2 vázající insulinu podobné růstové faktory * krev MeSH
- retrospektivní studie MeSH
- senioři MeSH
- urologické nádory chirurgie krev patologie mortalita MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
INTRODUCTION: We evaluate the predictive and prognostic value of insulin-like growth factor-I (IGF-1), IGF binding protein-2 (IGFBP-2) and -3 (IGFBP-3) in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS: This is a retrospective analysis of a multi-institutional database comprising 753 patients who underwent RNU for UTUC and had a preoperative plasma available. Logistic and Cox regression analyses were performed. The discriminative ability and clinical utility of the models was calculated using the lasso regression test, area under receiver operating characteristics curves, C-index, and decision curve analysis (DCA). RESULTS: Lower preoperative plasma levels of IGFBP-2 and -3 independently correlated with increased risks of lymph node metastasis, pT3/4 disease, nonorgan confined disease, and worse recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) (all P ≤ .004). The addition of both IGFBP-2 and -3 to a postoperative multivariable model, that included standard clinicopathologic characteristics, improved the model's concordance index by 10%, 9%, and 8% for RFS, CSS, and OS, respectively. On DCA, addition of both IGFBP-2 and -3 to base models improved their performance for RFS, CSS, and OS by a statistically and clinically significant margin. Plasma IGF-1 was not associated with any of outcomes. CONCLUSIONS: We confirmed that a lower plasma levels of IGFBP-2 and -3 both are independent and clinically significant predictors of adverse pathological features and survival outcomes in UTUC patients treated with RNU. These findings might help guide the clinical decision-making regarding perioperative systemic therapy and follow-up scheduling.
Departement of Urology Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Department of Special Surgery Division of Urology The University of Jordan Amman Jordan
Department of Surgery S H Ho Urology Centre The Chinese University of Hong Kong Hong Kong SAR China
Department of Surgical Sciences Division of Urology Torino School of Medicine Turin Italy
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Jagiellonian University Cracow Poland
Department of Urology Jikei University School of Medicine Tokyo Japan
Department of Urology Semmelweis University Budapest Hungary
Department of Urology Shariati Hospital Tehran University of Medical Sciences Tehran Iran
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University of Texas Southwestern Medical Center Dallas TX
Departments of Urology Weill Cornell Medical College New York NY
Citace poskytuje Crossref.org
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- $a Kardoust Parizi, Mehdi $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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- $a Preoperative Plasma Insulin-Like Growth Factor-I and Its Binding Proteins-Based Risk Stratification of Patients Treated With Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma / $c M. Kardoust Parizi, M. Rouprêt, N. Singla, JY. Teoh, P. Chlosta, M. Babjuk, M. Abufaraj, V. Margulis, D. D'Andrea, J. Klemm, A. Matsukawa, E. Laukhtina, T. Fazekas, PI. Karakiewicz, R. Bhanvadia, P. Gontero, SF. Shariat
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- $a INTRODUCTION: We evaluate the predictive and prognostic value of insulin-like growth factor-I (IGF-1), IGF binding protein-2 (IGFBP-2) and -3 (IGFBP-3) in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS: This is a retrospective analysis of a multi-institutional database comprising 753 patients who underwent RNU for UTUC and had a preoperative plasma available. Logistic and Cox regression analyses were performed. The discriminative ability and clinical utility of the models was calculated using the lasso regression test, area under receiver operating characteristics curves, C-index, and decision curve analysis (DCA). RESULTS: Lower preoperative plasma levels of IGFBP-2 and -3 independently correlated with increased risks of lymph node metastasis, pT3/4 disease, nonorgan confined disease, and worse recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) (all P ≤ .004). The addition of both IGFBP-2 and -3 to a postoperative multivariable model, that included standard clinicopathologic characteristics, improved the model's concordance index by 10%, 9%, and 8% for RFS, CSS, and OS, respectively. On DCA, addition of both IGFBP-2 and -3 to base models improved their performance for RFS, CSS, and OS by a statistically and clinically significant margin. Plasma IGF-1 was not associated with any of outcomes. CONCLUSIONS: We confirmed that a lower plasma levels of IGFBP-2 and -3 both are independent and clinically significant predictors of adverse pathological features and survival outcomes in UTUC patients treated with RNU. These findings might help guide the clinical decision-making regarding perioperative systemic therapy and follow-up scheduling.
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- $a Rouprêt, Morgan $u Department of Urology, Pitié Salpêtrière Hospital, AP-HP, GRC 5, Predictive Onco-Urology, Sorbonne University, Paris, France
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- $a Singla, Nirmish $u Departement of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University, Baltimore, MD
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- $a Laukhtina, Ekaterina $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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- $a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Special Surgery, Division of Urology, The University of Jordan, Amman, Jordan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Departments of Urology, Weill Cornell Medical College, New York, NY; Departement of Urology, Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Research Center for Evidence Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: sfshariat@gmail.com
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