Prognostic Implications of Postoperative Serum CYFRA Levels in Upper Tract Urothelial Carcinoma.

IF 1.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Nippon Medical School Pub Date : 2025-01-01 DOI:10.1272/jnms.JNMS.2025_92-404

Yuki Endo, Jun Akatsuka, Hayato Takeda, Masato Yanagi, Yuka Toyama, Kotaro Obayashi, Hikaru Mikami, Shunsuke Ikuma, Hiroya Hasegawa, Mami Takadate, Honami Inoue, Tsutomu Hamasaki, Go Kimura, Yukihiro Kondo

{"title":"Prognostic Implications of Postoperative Serum CYFRA Levels in Upper Tract Urothelial Carcinoma.","authors":"Yuki Endo, Jun Akatsuka, Hayato Takeda, Masato Yanagi, Yuka Toyama, Kotaro Obayashi, Hikaru Mikami, Shunsuke Ikuma, Hiroya Hasegawa, Mami Takadate, Honami Inoue, Tsutomu Hamasaki, Go Kimura, Yukihiro Kondo","doi":"10.1272/jnms.JNMS.2025_92-404","DOIUrl":null,"url":null,"abstract":"Background: Current guidelines lack recommendations for serum tumor markers in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). This study assessed the potential of the postoperative serum C-terminus of cytokeratin 19 (CYFRA21-1, CYFRA) level, hereafter referred to as poCY, as a predictor of early progression in patients treated with RNU.Methods: Overall, 117 patients were categorized into the high group (HG) or low group (LG) based on a poCY cutoff level of 3.5 ng/mL after excluding those who did not meet the inclusion criteria. Kaplan-Meier curves and log-rank tests were used to measure cancer-specific survival (CSS) and progression-free survival (PFS) rates. Multivariate analysis was performed using the Cox proportional hazards model.Results: During a median follow-up of 34 months, the 5-year CSS and PFS rates were 79% and 66%, respectively. The HG had a significantly worse CSS and 2-year PFS than the LG. Multivariate analyses identified poCY and lymph node involvement (LNI) as independent prognostic factors. Regarding the 2-year PFS, poCY, LNI, and resection margin status (RM) emerged as independent prognostic factors.Conclusions: poCY, LNI, and RM predicted early progression following RNU in patients with UTUC. Patients with elevated poCY may benefit from adjuvant chemotherapy, irrespective of their pathological findings.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"92 4","pages":"321-330"},"PeriodicalIF":1.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nippon Medical School","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1272/jnms.JNMS.2025_92-404","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Current guidelines lack recommendations for serum tumor markers in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). This study assessed the potential of the postoperative serum C-terminus of cytokeratin 19 (CYFRA21-1, CYFRA) level, hereafter referred to as poCY, as a predictor of early progression in patients treated with RNU.

Methods: Overall, 117 patients were categorized into the high group (HG) or low group (LG) based on a poCY cutoff level of 3.5 ng/mL after excluding those who did not meet the inclusion criteria. Kaplan-Meier curves and log-rank tests were used to measure cancer-specific survival (CSS) and progression-free survival (PFS) rates. Multivariate analysis was performed using the Cox proportional hazards model.

Results: During a median follow-up of 34 months, the 5-year CSS and PFS rates were 79% and 66%, respectively. The HG had a significantly worse CSS and 2-year PFS than the LG. Multivariate analyses identified poCY and lymph node involvement (LNI) as independent prognostic factors. Regarding the 2-year PFS, poCY, LNI, and resection margin status (RM) emerged as independent prognostic factors.

Conclusions: poCY, LNI, and RM predicted early progression following RNU in patients with UTUC. Patients with elevated poCY may benefit from adjuvant chemotherapy, irrespective of their pathological findings.

查看原文本刊更多论文

上尿路上皮癌术后血清CYFRA水平对预后的影响。

背景：目前的指南缺乏对接受根治性肾输尿管切除术（RNU）的上尿路上皮癌（UTUC）患者血清肿瘤标志物的建议。本研究评估了术后血清c端细胞角蛋白19 （CYFRA21-1， CYFRA）水平（以下简称poCY）作为RNU治疗患者早期进展的预测因子的潜力。方法：在排除不符合纳入标准的患者后，根据3.5 ng/mL的政策临界值将117例患者分为高组（HG）和低组（LG）。Kaplan-Meier曲线和log-rank检验用于测量癌症特异性生存（CSS）和无进展生存（PFS）率。采用Cox比例风险模型进行多因素分析。结果：中位随访34个月，5年CSS和PFS率分别为79%和66%。HG组的CSS和2年PFS明显低于LG组。多变量分析发现前列腺癌和淋巴结受累（LNI）是独立的预后因素。对于2年PFS， policy、LNI和切除边缘状态（RM）成为独立的预后因素。结论：poCY、LNI和RM预测了UTUC患者RNU后的早期进展。poCY升高的患者可能受益于辅助化疗，无论其病理表现如何。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-

CiteScore

1.80

自引率

10.00%

发文量

118

期刊介绍： The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.