BACKGROUND: To characterize the stage-specific prognostic relevance of preoperative systemic inflammatory response, defined by C-reactive protein (CRP), in colon cancer (CC) patients. MATERIAL AND METHODS: Data from CC patients operated on from 1998 to 2007 at three hospitals from three different Nordic countries were collected retrospectively from national registries, local databases and/or patient records. Patients with emergency surgery, infection or auto-immune disease were excluded. Associations between clinical or histopathological variables and CRP were assessed. Patients were followed from the date of surgery to death or end of follow-up. Disease-specific survival (DSS) was the main endpoint. RESULTS: In total, 525 patients with age and stage distributions which were representative for CC patients were included. None of the patients was lost to follow-up. Age, TNM Stage, WHO differentiation grade and right-sided tumor location significantly associated with elevated CRP values, in contrast to postoperative morbidity, which did not. CRP levels were found to be a strong prognostic factor for DSS in CC. The risk of death due to CC was augmented with increasing levels of CRP in every stage of operated CC. Both short- and long-term DSS were impaired. The sub-hazard ratios for CRP-levels above 60 mg/L were 7.37 (CI 2.65-20.5) for stage I+ II, compared to 3.29 (CI 1.30-8.29) for stage III and 2.24 (CI 1.16-4.35) for stage IV. CONCLUSION: Increase of CRP concentrations correlate with clinically relevant poorer disease-specific survival in each stage of CC.
BACKGROUND: To characterize the stage-specific prognostic relevance of preoperative systemic inflammatory response, defined by C-reactive protein (CRP), in colon cancer (CC) patients. MATERIAL AND METHODS: Data from CC patients operated on from 1998 to 2007 at three hospitals from three different Nordic countries were collected retrospectively from national registries, local databases and/or patient records. Patients with emergency surgery, infection or auto-immune disease were excluded. Associations between clinical or histopathological variables and CRP were assessed. Patients were followed from the date of surgery to death or end of follow-up. Disease-specific survival (DSS) was the main endpoint. RESULTS: In total, 525 patients with age and stage distributions which were representative for CC patients were included. None of the patients was lost to follow-up. Age, TNM Stage, WHO differentiation grade and right-sided tumor location significantly associated with elevated CRP values, in contrast to postoperative morbidity, which did not. CRP levels were found to be a strong prognostic factor for DSS in CC. The risk of death due to CC was augmented with increasing levels of CRP in every stage of operated CC. Both short- and long-term DSS were impaired. The sub-hazard ratios for CRP-levels above 60 mg/L were 7.37 (CI 2.65-20.5) for stage I+ II, compared to 3.29 (CI 1.30-8.29) for stage III and 2.24 (CI 1.16-4.35) for stage IV. CONCLUSION: Increase of CRP concentrations correlate with clinically relevant poorer disease-specific survival in each stage of CC.
Authors: Adomas Bunevicius; Andrius Radziunas; Sarunas Tamasauskas; Arimantas Tamasauskas; Edwards R Laws; Giorgio Iervasi; Robertas Bunevicius; Vytenis Deltuva Journal: J Neurooncol Date: 2018-02-19 Impact factor: 4.130
Authors: T Grimm; A Buchner; B Schneevoigt; A Kretschmer; M Apfelbeck; M Grabbert; J F Jokisch; C G Stief; A Karl Journal: World J Urol Date: 2015-09-16 Impact factor: 4.226
Authors: Marianne R F Bosscher; Esther Bastiaannet; Barbara L van Leeuwen; Harald J Hoekstra Journal: Ann Surg Oncol Date: 2015-11-09 Impact factor: 5.344