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
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study
PubMed
38945766
DOI
10.1016/j.clgc.2024.102133
PII: S1558-7673(24)00104-6
Knihovny.cz E-resources
- Keywords
- IGF-1, IGFBP-2, IGFBP-3, Upper tract, Urothelial carcinoma,
- MeSH
- Risk Assessment methods MeSH
- Insulin-Like Growth Factor Binding Protein 3 blood MeSH
- Insulin-Like Growth Factor I * metabolism MeSH
- Carcinoma, Transitional Cell surgery blood pathology mortality MeSH
- Middle Aged MeSH
- Humans MeSH
- Biomarkers, Tumor blood MeSH
- Nephroureterectomy * methods MeSH
- Insulin-Like Peptides MeSH
- Preoperative Period MeSH
- Prognosis MeSH
- Insulin-Like Growth Factor Binding Protein 2 * blood MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Urologic Neoplasms surgery blood pathology mortality MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Names of Substances
- IGF1 protein, human MeSH Browser
- Insulin-Like Growth Factor Binding Protein 3 MeSH
- IGFBP2 protein, human MeSH Browser
- IGFBP3 protein, human MeSH Browser
- Insulin-Like Growth Factor I * MeSH
- Biomarkers, Tumor MeSH
- Insulin-Like Peptides MeSH
- Insulin-Like Growth Factor Binding Protein 2 * 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.
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 University of Texas Southwestern Medical Center Dallas TX
References provided by Crossref.org