Mp03-17 Systematic Evaluation of Laboratory Values Associated With Survival in Metastatic Renal Cell Carcinoma
Year: 2016
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND OBJECTIVES: Current prognostic models of metastatic RCC (mRCC) include tumor characteristics (e.g.stage, grade), patient factors (e.g.performance status), and select laboratory values.A comprehensive laboratory-based prognostic panel remains elusive and each laboratory tests relative value remains unknown.To address this challenge, our group has developed a Laboratory-Wide Association Study (LWAS) framework to systematically evaluate laboratory exposures associated with outcome in a national cohort of patients with mRCC.METHODS: We included all patients diagnosed with mRCC (N or M stage >0) between 2002 and 2012 in the VA.We abstracted patient age, sex, BMI, Charlson Score, and receipt of cytoreductive nephrectomy.Overall survival (OS) was determined using the VA Vital Status File.All available serum-based laboratory measures were identified in a period 6 months prior to diagnosis through 1 month after diagnosis.A LWAS analysis was performed as outlined in the figure.RESULTS: We identified 278,902 serum lab values in 2,339 patients.19 factors were associated with worse OS while 17 were associated with improved OS.We validated several known lab values associated with mRCC OS: Hgb (HR 0.82 95%CI 0.81-0.84),Ca (HR 0.98, 95%CI 0.96-0.99),PLT (HR 1.16 95%CI 1.12-1.20),WBC (HR 1.02, 95%CI 1.101-1.03),Alk Phos (HR 1.26, 95%CI 1.24-1.29),Albumin (HR 0.69, 95%CI 0.66-0.71),and TSH (HR 1.07, 95%CI 1.01-1.14).C reactive protein was associated with the greatest hazard of mortality (HR 1.68, 95%CI 1.34-2.11).Additional novel associations were also detected.CONCLUSIONS: The LWAS framework is a novel platform to systematically test for associations among lab values and clinical outcomes that can be applied on a broad scale.When applied in a large national integrated health care system with an electronic medical record, LWAS validated many known lab values associated with OS and identified novel lab values that may improve prognostic models for these patients.
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2313616231