Preoperative Serum Cystatin C As an Independent Prognostic Factor for Survival in Patients with Renal Cell Carcinoma

Overview

Journal J Cancer

Specialty Oncology

Date 2024 Oct 23

PMID 39440052

Authors

Hui Ma

Peipei Wang

Zhao Hou

Huiyu Zhou

Dingyang Lv

Fan Cui

Weibing Shuang

Affiliations

Soon will be listed here.

Abstract

This study aims to evaluate the prognostic significance of preoperative serum cystatin C (Cys-C) in patients with renal cell carcinoma (RCC). We analyzed clinicopathological data and follow-up information of 624 RCC patients who underwent partial or radical nephrectomy at our institution. The optimal cutoff value of Cys-C was determined using X-tile software. Survival outcomes, including overall survival (OS) and cancer-specific survival (CSS), were evaluated using the Kaplan-Meier method and log-rank test. To avoid overfitting and collinearity, we used LASSO-based multivariable Cox regression analysis to identify independent predictors of OS and CSS. The predictive accuracy of the established model, including preoperative serum Cys-C, was evaluated using the time-dependent receiver operating characteristic (ROC) curves and the area under the curve (AUC). The median follow-up period was 40 months. The optimal cutoff value of preoperative serum Cys-C levels was 0.95 mg/L. Compared with the low Cys-C group, patients in the high Cys-C group had significantly shorter OS and CSS. Multivariable Cox regression analysis indicated that elevated preoperative serum Cys-C level was an independent adverse predictor for RCC patients post-nephrectomy. After adjusting for all covariates, high preoperative serum Cys-C level was associated with worse OS (hazard ratio [HR]: 2.254; 95% confidence interval [CI]: 1.144, 4.439; = 0.019) and CSS (HR: 3.621; 95% CI: 1.386, 9.456; = 0.009). Time-dependent ROC analysis demonstrated that our model, including preoperative serum Cys-C, performed well in predicting accuracy of survival. Preoperative serum Cys-C level is an effective prognostic indicator for OS and CSS in RCC patients undergoing nephrectomy.

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