Plasma soluble urokinase-type Plasminogen Activator Receptor (suPAR) predicts disease aggressiveness in renal cell carcinoma (ccRCC), but its prognostic accuracy has not been investigated. To investigate the prognostic accuracy of preoperative plasma suPAR in patients who received curative treatment for initially localized ccRCC.
We retrospectively analyzed plasma samples stored in the Danish National Biobank between 2010 and 2015 from 235 patients with ccRCC at any stage. Relationships with outcome analyzed using univariate and multiple logistic Cox regression analysis.
There were 235 patients with ccRCC. The median follow-up period was 7.7 years. In univariate analysis suPAR ≥ 6 ng/mL was significantly associated with overall survival (OS) and recurrence-free survival (RFS). Patients with elevated suPAR were more likely to recur, with a Hazard Ratio (HR) of 2.3 for RFS. In multiple logistic regression, suPAR ≥ 6 ng/mL remained a negative predictor of OS and RFS. Limitations include retrospective study design, wide confidence intervals, and tumor subtype heterogeneity bias.
ccRCC patients with high plasma suPAR concentrations are at an elevated risk of disease recurrence and see lower OS. suPAR is a promising surveillance tool to more precisely follow up with ccRCC patients and detect future recurrences. In this study, we showed that new type of liquid marker in blood plasma, called suPAR, is associated to a higher risk of kidney cancer recurrence when elevated above 6ng/mL. We also showed suPAR to independently be able to predict patients overall and recurrence free survival in patient with any stage of kidney cancer.
BMC urology. 2023 Oct 24*** epublish ***
Nessn Azawi, Karina Sif Sondergaard Mosholt, Nathalie Demuth Fryd, Lars Lund, Juan Ignacio Brignone, Nanna Hvid, Helle Wulf-Johansson, Ole Birger Vesterager Pedersen, Susanne Gjørup Saekmose, Saeed Dabestani
Department of Urology, Zealand University Hospital, Sygehusvej 6, Roskilde, 4000, Denmark. ., Department of Urology, Zealand University Hospital, Sygehusvej 6, Roskilde, 4000, Denmark., Deparment of Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Aarhus, Denmark., Deparment of Urology, Odense University Hospital, J. B. Winslows Vej 4, Odense, 5000, Denmark., Department of Urology, Aalborg University hospital, Hobrovej 18-22, Aalborg, Aalborg, 9100, Denmark., Department of Clinical Immunology, Naestved Hospital, Ringstedgade 61, Naestved, Naestved, 4700, Denmark., Department of Urology, Kristianstad Central Hospital, Region Skane, Kristianstad, Sweden.