Prognostic Importance of Vitamins A, E and Retinol-binding Protein 4 in Renal Cell Carcinoma Patients

Anticancer Res. 2017 Jul;37(7):3801-3806. doi: 10.21873/anticanres.11757.

Abstract

Aim: To assess the prognostic importance of serum levels of retinol, retinol-binding protein 4 (RBP4) and vitamin E at the time of diagnosis in patients with renal cell carcinoma (RCC).

Patients and methods: In this prospective study, in a cohort of 102 renal cell carcinoma patients, relationships between serum levels of the aforementioned markers and recurrence-free survival (RFS), overall survival (OS), as well as cancer-specific survival (CSS), were evaluated. The vitamin A and vitamin E levels were determined by high-performance liquid chromatography (HPLC), while the RBP4 level by enzyme-linked immunosorbent assay (ELISA).

Results: The median follow-up period was 39 months. Renal cell carcinoma recurred in 9 patients; 23 patients died with 12 of them from RCC. The preoperative vitamin E level was associated to RFS (p=0.02). We found a significant relationship between OS and the level of RBP4 (p=0.002), retinol (p=0.037) and vitamin E (p=0.007). The CSS period was significantly associated with the level of RBP4 (p=0.0001) and retinol (p=0.0003). Patients with an RBP4 level less than 21.0 mg/l at the time of diagnosis had a 13.5-times higher risk of death due to RCC progression; this risk was up to 7.7-times higher with vitamin A levels under 0.52 mg/l.

Conclusion: Low levels of vitamin A, E and RBP4 at the time of RCC diagnosis are associated with a poorer prognosis after surgery.

Keywords: Renal cell carcinoma; disease-specific survival; overall survival; prognosis; recurrence-free survival; retinol-binding protein; vitamin A; vitamin E.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / blood*
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / surgery
  • Female
  • Humans
  • Kidney Neoplasms / blood*
  • Kidney Neoplasms / diagnostic imaging
  • Kidney Neoplasms / surgery
  • Male
  • Middle Aged
  • Nephrectomy
  • Preoperative Period
  • Prognosis
  • Retinol-Binding Proteins, Plasma / analysis*
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Vitamin A / blood*
  • Vitamin E / blood*
  • Vitamins / blood*
  • Young Adult

Substances

  • RBP4 protein, human
  • Retinol-Binding Proteins, Plasma
  • Vitamins
  • Vitamin A
  • Vitamin E