Introduction

No serum prognosticator has been established in patients with potentially lethal bladder cancer. The aim of this study is to evaluate the prognostic impact of serum CYFRA 21-1 (CYFRA) in these patients compared with classic tumor markers.

Methods

Serum levels of CYFRA and other classic tumor markers: CA19-9, SCC, and C-reactive protein (CRP) were measured in 66 patients with T1G3 (n = 20) or muscle invasive bladder cancer (n = 46) without metastasis between Jan 2011 and Aug 2015. Cut-off values of the tumor markers were determined by receiver operating characteristic analyses. Prognostic values of age, gender, T stage, hydronephrosis, albumin, hemoglobin, CA19-9, SCC, CRP, and CYFRA were evaluated using multivariate analysis with a Cox proportional hazards model.

Results

The median (range) value of CYFRA was 2.6 (1.1-34) ng/mL. The median follow-up period was 24.3 (1.1-58.1) months. Prognostic values of age (< 73 vs. ≥ 73), T stage (< T2 vs. ≥ T2), hydronephrosis (absence vs. presence), albumin (cut-off 4.0 g/dL, median), hemoglobin (cut-off 12.7 g/dL, median), CA19-9 (cut-off 21 U/mL), SCC (cut-off 1.5 ng/mL), CRP (cut-off 0.1 mg/dL), and CYFRA (cut-off 3.5 ng/mL) were evaluated dichotomously. Multivariate analyses revealed that CYFRA (p = 0.017) was the only significant and independent predictor of cancer-specific survival. Risk of cancer-specific mortality was 4.48-fold (95% CI, 1.37-18.27; p = 0.012) higher in CYFRA-high patients than in CYFRA-low/either classic tumor marker-high patients._x000D_ _x000D_ Figure. Cancer-specific survival curves according to CYFRA and classic tumor markers status

Conclusions

The current results indicated that cancer-specific mortality of non-metastatic bladder cancer could be better predicted by CYFRA than other previously reported tumor markers. Further prospective analyses will be needed to confirm our results.

Funding

none