Prognostic values of blood urea nitrogen/creatinine and cystatin C in patients with radical nephrectomy for renal cell carcinoma
Abstract
Background: To evaluate the prognostic value of blood urea nitrogen/creatinine ratio (BUN/SCr) and cystatin C (Cys C) in patients with renal cell carcinoma (RCC) after radical nephrectomy.
Methods: The study analyzed 348 patients with RCC who underwent radical nephrectomy. The optimal cutoff was obtained based on the ROC of specific survival outcomes and the maximum Youden index, and the patients were divided into four groups: Group 1 (low BUN/SCr-low Cys C), Group 2 (low BUN/SCr-high Cys C), Group 3 (high BUN/SCr-low Cys C) and Group 4 (high BUN/SCr-high Cys C). The primary endpoint was cancer-specific survival (CSS) and the secondary endpoint was disease-free survival (DFS).
Results: A strong positive correlation was shown between BUN/SCr value and Cys C level. Patients with a higher BUN/SCr ratio (17.41) and Cys C level (3.98 mg/L) had poorer survival outcomes. Notably, patients in group 4 showed the worst CSS and DFS rates, while patients in groups 1 and 2 had better survival outcomes with no significant difference between the two groups. A higher BUN/SCr ratio (17.41) and high Cys C serum level (3.98 mg/L) were independent predictors of CSS and DFS, in addition to preoperative tumor size and pathological T (pT) stage.
Conclusion: This study provides the first evidence of the independent prognostic importance of BUN/SCr ratio and Cys C in patients with RCC after radical nephrectomy.
Copyright (c) 2023 SiCheng Wang, HaoLong Chen, Chao Feng, Bin Jia
This work is licensed under a Creative Commons Attribution 4.0 International License.
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.