Mp38-07 Interleukin-6 and Its Soluble Receptor as Blood-Based Biomarkers Predicting Disease Outcomes After Radical Nephroureterectomy in Patients With Upper Tract Urothelial Carcinoma

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)1 May 2024MP38-07 INTERLEUKIN-6 AND ITS SOLUBLE RECEPTOR AS BLOOD-BASED BIOMARKERS PREDICTING DISEASE OUTCOMES AFTER RADICAL NEPHROURETERECTOMY IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA Heidemarie Ofner, Ekaterina Laukhtina, Morgan Roupret, Jeremy Yuen-Chun Teoh, Peter Nyirady, Piotr Chlosta, Mohammad Abufaraj, Marek Babjuk, Vitaly Margulis, David D'Andrea, Jakob Klemm, Mehdi K. Parizi, Akihiro Matsukawa, and Shahrokh F. Shariat Heidemarie OfnerHeidemarie Ofner , Ekaterina LaukhtinaEkaterina Laukhtina , Morgan RoupretMorgan Roupret , Jeremy Yuen-Chun TeohJeremy Yuen-Chun Teoh , Peter NyiradyPeter Nyirady , Piotr ChlostaPiotr Chlosta , Mohammad AbufarajMohammad Abufaraj , Marek BabjukMarek Babjuk , Vitaly MargulisVitaly Margulis , David D'AndreaDavid D'Andrea , Jakob KlemmJakob Klemm , Mehdi K. PariziMehdi K. Parizi , Akihiro MatsukawaAkihiro Matsukawa , and Shahrokh F. ShariatShahrokh F. Shariat View All Author Informationhttps://doi.org/10.1097/01.JU.0001008700.92603.b1.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Blood-based inflammatory biomarkers have become an attractive field of research in different malignancies in recent years, among these are interleukin-6 (IL-6) and its soluble receptor (IL6SR). We aimed to evaluate the prognostic impact of IL-6 and IL6SR in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS: A retrospective analysis of a large-scale multi-institutional UTUC database was conducted. The preoperatively measured IL-6 and IL6SR were investigated as predictors of survival outcomes after RNU. Univariable and multivariable Cox regression models were used to analyze the association of IL-6 and IL6SR with recurrence-free (RFS), cancer-specific (CSS) and overall (OS) survival. The discrimination of the models were evaluated with the Harrel's concordance index (C-index). The clinical value of IL-6 and IL6SR were evaluated with decision curve analysis (DCA). RESULTS: We included 754 patients in this retrospective data analysis. The overall population was devided into groups depending on the mean as a cut-off of IL-6 and IL6SR (low, <2.7pg/ml vs. high, ≥2.7pg/ml and low, <24ng/ml vs high, ≥24ng/ml, respectively). High IL-6 was associated with lymph node involvement (p<0.001); a high IL6SR was also associated with positive lymph nodes (p<0.001) as well as higher stage (p=0.002) and grade of disease (p=0.02).During the median follow-up of 34 months, 190 patients experienced a disease recurrence, and 260 patients died, among these 172 died because of the disease. High IL-6 and IL6SR were significantly associated with worse RFS, CSS and OS in univariable analysis (all p<0.001). In multivariable analysis adjusted for effects of clinicopathologic features, IL-6 remained associated with RFS (HR 1.72, 95%CI 1.28-2.32, p<0.001), CSS (HR 1.74, 95%CI 1.27-2.38, p<0.001) and OS (HR 1.46, 95%CI 1.13-1.87, p=0.003). IL6SR also remained associated with RFS (HR 1.81, 95%CI 1.32-2.47, p<0.001), CSS (HR 1.67, 95%CI 1.19-2.32, p=0.003) and OS (HR 1.33, 95%CI 1.03-1.72, p=0.03).The addition of IL-6 and IL6SR minimally improved the discrimination of a base model for RFS (C-index 0.803 vs. 0.794 for IL-6, C-index 0.803 vs. 0.794 for IL6SR), CSS (C-index 0.801 vs. 0.796 for IL-6, C-index 0.802 vs. 0.796 for IL6SR) and OS (C-index 0.743 vs. 0.734 for IL-6 and C-index 0.739 vs. 0.734 for IL6SR). On DCA, the inclusion of IL-6 only marginally improved the net benefit of the prognostic model and IL6SR did not show a beneficial effect. CONCLUSIONS: High IL-6 and IL6SR were associated with aggressive disease and worse survival outcomes in UTUC patients treated with RNU. IL-6 and IL6SR might be helpful markers for prognostication of disease. To investigate their net benefit for clinical decision-making, further investigations are needed. Source of Funding: no source of funding © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e643 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Heidemarie Ofner More articles by this author Ekaterina Laukhtina More articles by this author Morgan Roupret More articles by this author Jeremy Yuen-Chun Teoh More articles by this author Peter Nyirady More articles by this author Piotr Chlosta More articles by this author Mohammad Abufaraj More articles by this author Marek Babjuk More articles by this author Vitaly Margulis More articles by this author David D'Andrea More articles by this author Jakob Klemm More articles by this author Mehdi K. Parizi More articles by this author Akihiro Matsukawa More articles by this author Shahrokh F. Shariat More articles by this author Expand All Advertisement PDF downloadLoading ...