Patel SH, et al. - In this retrospective international three center analysis, researchers assessed whether pre-treatment C-reactive protein (CRP) can predict survival and oncological outcomes in a multicenter cohort of renal cell carcinoma (RCC) patients. They considered CRP > 0.5mg/dl as threshold for elevation. Patients were defined as normal-CRP (≤0.5) or elevated-CRP (> 0.5). This study included 2,695 patients followed for a mean of 36 months (1,791 Male/904 female, CRP≤0.5 1,198/CRP > 0.5 1,496). In multivariable analyses for recurrence-free survival (RFS), the identified independent risk factors included elevated CRP, increasing tumor size, and high tumor grade. In Kaplan-Meier analyses, the estimated 5-year RFS for normal vs elevated CRP was 90% vs 85%, 95% vs 85%, 85% vs 62%, 50% vs 60% for stages 1, 2, 3, and 4, respectively, and the respective 5-year overall survival was 98% vs 80%, 95% vs 80%, 95% vs 65%, 99% vs 40%. In the studied multicenter cohort of RCC patients, recurrence-free survival and overall survival were independently predicted by pre-treatment CRP. The inclusion of CRP into nomographic and risk stratification protocols was recommended.