(ChemotherapyAdvisor) – Erythrocyte sedimentation rate (ESR) and anemia predict survival among patients with clear cell renal cell carcinoma (ccRCC), according to a Korean study published online in the British Journal of Cancer.

“Preoperative high ESR, but not ALP [alkaline phosphatase enzyme], was a significant predictor for cancer-specific survival (CSS) among ccRCC patients,” reported Y. Choi, MD, MPH, of the Women’s Health Research Institute, Sookmyung Women’s University, in Seoul, Koera, and coauthors.

“Our findings suggest that preoperative ESR is an independent prognostic indicator for CSS and anemia is related to a high risk of death due to other causes than RCC among patients with ccRCC,” they reported.


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The authors analyzed ESR, ALP, hemoglobin, and hematocrit levels for a total of 1,307 patients who underwent nephrectomy for ccRCC, and compared these measures to survival outcomes. At a median follow-up of 43 months, patients with elevated preoperative ESR had more than twice the risk of dying from RCC compared to patients with low ESR levels (hazard ratio [HR] 2.10; 95% CI: 1.21-3.67), the authors reported. Anemic patients had elevated HRs for overall survival (HR 3.11; 95% CI: 1.17-8.25) but not cancer-specific mortality.

Associations between ESR and cancer-specific mortality, and between anemia and non-cancer mortality, were “more pronounced in patients with body mass index (BMI) less than 25 compared to patients with BMI 25 or higher,” they noted.

ALP levels “may be a sensitive indicator of bone or liver metastasis, as ALP levels can reflect liver or bone dysfunction,” the authors noted.

Abstract