https://doi.org/10.4081/aiua.2023.11242

C reactive protein/Albumin ratio as predictor of prognosis in castration resistant metastatic prostate cancer

Vol. 95 No. 3 (2023)
Submitted: February 6, 2023
Accepted: February 25, 2023
Published: July 11, 2023
Prostatic cancer, C-reactive protein, Albumin, Biomarker, Prognosis
Abstract Views: 884
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Authors

João Lorigo
joaolorigo@gmail.com
https://orcid.org/0000-0001-9585-2609
Department of Urology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Edgar Tavares Silva
https://orcid.org/0000-0002-8612-0147
Department of Urology, Centro Hospitalar e Universitário de Coimbra, Coimbra; University, Coimbra, Portugal.
João Pedroso Lima
https://orcid.org/0000-0001-6955-2485
Department of Urology, Centro Hospitalar e Universitário de Coimbra, Coimbra; University, Coimbra, Portugal.
Vasco Quaresma
Department of Urology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Rui Pedrosa
Department of Urology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Arnaldo Figueiredo
https://orcid.org/0000-0002-7157-0081
Department of Urology, Centro Hospitalar e Universitário de Coimbra, Coimbra; University, Coimbra, Portugal.

Objective: To assess the association of C reactive protein/Albumin ratio (CAR) with progression free survival (PFS) and overall survival (OS) in castration resistant metastatic prostate cancer (mCRPC) patients. Materials and methods: A transversal study was conducted, including all patients diagnosed with mCRPC within a Central Hospital Urological Oncology consultation between December 2019 and December 2021 (n = 178) and that were submitted to systemic therapy. CRP and albumin results were collected at the beginning of the systemic treatment for mCRPC in 103 patients and, in 75 patients already under treatment at the start of the study, on that occasion (December 2019). All patients were then followed. CAR was correlated with PFS and OS. OS and PFS were measured from the day the CRP and Alb were collected until the event of interest or the final date of follow-up. The sample was divided in two groups according to an optimal cutoff point found in a ROC curve. Results: The sample showed a median age of 75.76 ± 9.17 years old. Using a cut-off point of 0.22, patients with a CAR ≤ 0.22 (63.2%) showed, compared to CAR > 0.22, longer PFS (15.92 vs. 9.46 months, r = -0.13, p < 0.05) and OS (p = < 0.05, 25,72 vs. 15.79 months, r = -0,24, p < 0.05). Better OS in patients with CAR ≤ 0.22 vs > 0.22 was detected on both the group evaluated at the beginning of systemic treatment (26.96 vs 17.63 months, p < 0.05) and the group of patients already under treatment (23.90 vs 11.54 months, p < 0.05). Dividing the sample according to the first line treatment chosen, we found OS of 26.25 vs 5.9 months (p < 0.05), 27.71 vs 22.57 months (p < 0.05) and 27.36 vs 23.75 months (p = 0.12), for docetaxel, abiraterone and enzalutamide, respectively. Conclusions: According to this study, higher values of CAR are associated with lower PFS and OS in mCRPC patients. We found a cut-off value of 0.22 providing the best discrimination for prognosis. CAR is a good prognosis biomarker, irrespective of the moment of evaluation and chosen treatment option.

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How to Cite

Lorigo, J., Tavares Silva, E., Pedroso Lima, J., Quaresma, V., Pedrosa, R., & Figueiredo, A. (2023). C reactive protein/Albumin ratio as predictor of prognosis in castration resistant metastatic prostate cancer. Archivio Italiano Di Urologia E Andrologia, 95(3). https://doi.org/10.4081/aiua.2023.11242
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