Eva-Maria Thurner1, Sabine Krenn-Pilko1, Uwe Langsenlehner2, Tatjana Stojakovic3, Martin Pichler4, Armin Gerger5, Karin S Kapp1, Tanja Langsenlehner6. 1. Department of Therapeutic Radiology and Oncology, Medical University of Graz, Austria. 2. Division of Internal Medicine, Outpatient Department Graz, Austria. 3. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria. 4. Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, TX, USA. 5. Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Austria. 6. Department of Therapeutic Radiology and Oncology, Medical University of Graz, Austria. Electronic address: tanja.langsenlehner@medunigraz.at.
Abstract
BACKGROUND: C-reactive protein (CRP) is a sensitive marker of inflammation that has been linked with prognosis in various solid tumours. In the present study, we analysed the prognostic relevance of elevated plasma CRP levels in prostate cancer patients treated with radiotherapy. METHODS: A total of 261 prostate cancer patients treated with 3D-conformal radiotherapy were evaluated retrospectively. Cancer specific survival (CSS), overall survival (OS) and clinical disease-free survival (DFS) were assessed using Kaplan-Meier analysis. To evaluate the independent prognostic significance of CRP plasma levels, multivariate Cox regression models were applied. RESULTS: The median follow-time was 80months. Applying receiver operating characteristics (ROC) analysis, the optimal cut-off level for the plasma CRP was 8.6mgl(-1). An elevated CRP level was associated with decreased CSS in univariate (hazard ratio (HR) 3.36, 95% confidence interval (CI) 1.42-7.91; p=0.006) and multivariate analysis (HR 4.31, 95% CI 1.22-15.1; p=0.023). Furthermore, a significant association with OS was detected in univariate (HR 2.69, 95% CI 1.57-4.59; p<0.001) and multivariate analyses (HR 3.24, 95% CI 1.84-5.71, p<0.001). Multivariate analysis also showed a significant association between plasma CRP and clinical DFS (HR 2.07, 95% CI 1.02-4.17; p=0.043). CONCLUSIONS: In the present study, an elevated plasma CRP (⩾8.6mgl(-1)) has been identified as a prognostic factor for poor CSS, OS and DFS in prostate cancer patients undergoing radiotherapy. The association between elevated CRP levels and poor prognosis was independent of other measures of prognosis such as tumour stage, Gleason grading and prostate specific antigen (PSA) level at diagnosis. If confirmed by additional studies, our findings may contribute to future individual risk assessment in prostate cancer patients.
BACKGROUND:C-reactive protein (CRP) is a sensitive marker of inflammation that has been linked with prognosis in various solid tumours. In the present study, we analysed the prognostic relevance of elevated plasma CRP levels in prostate cancerpatients treated with radiotherapy. METHODS: A total of 261 prostate cancerpatients treated with 3D-conformal radiotherapy were evaluated retrospectively. Cancer specific survival (CSS), overall survival (OS) and clinical disease-free survival (DFS) were assessed using Kaplan-Meier analysis. To evaluate the independent prognostic significance of CRP plasma levels, multivariate Cox regression models were applied. RESULTS: The median follow-time was 80months. Applying receiver operating characteristics (ROC) analysis, the optimal cut-off level for the plasma CRP was 8.6mgl(-1). An elevated CRP level was associated with decreased CSS in univariate (hazard ratio (HR) 3.36, 95% confidence interval (CI) 1.42-7.91; p=0.006) and multivariate analysis (HR 4.31, 95% CI 1.22-15.1; p=0.023). Furthermore, a significant association with OS was detected in univariate (HR 2.69, 95% CI 1.57-4.59; p<0.001) and multivariate analyses (HR 3.24, 95% CI 1.84-5.71, p<0.001). Multivariate analysis also showed a significant association between plasma CRP and clinical DFS (HR 2.07, 95% CI 1.02-4.17; p=0.043). CONCLUSIONS: In the present study, an elevated plasma CRP (⩾8.6mgl(-1)) has been identified as a prognostic factor for poor CSS, OS and DFS in prostate cancerpatients undergoing radiotherapy. The association between elevated CRP levels and poor prognosis was independent of other measures of prognosis such as tumour stage, Gleason grading and prostate specific antigen (PSA) level at diagnosis. If confirmed by additional studies, our findings may contribute to future individual risk assessment in prostate cancerpatients.
Authors: William A Hall; Theodore G Karrison; Seth A Rosenthal; Mahul B Amin; Leonard G Gomella; James A Purdy; A Oliver Sartor; Jeff M Michalski; Mark G Garzotto; Carmen Bergom; Ashesh B Jani; Colleen A F Lawton; Jeffry P Simko; Joan K Moore; Elizabeth M Gore; W Robert Lee; Paul L Nguyen; Brita L Danielson; Howard M Sandler; Felix Y Feng Journal: Int J Radiat Oncol Biol Phys Date: 2022-06-05 Impact factor: 8.013
Authors: S Sevcenco; R Mathieu; P Baltzer; T Klatte; H Fajkovic; C Seitz; P I Karakiewicz; M Rouprêt; M Rink; L Kluth; Q-D Trinh; W Loidl; A Briganti; D S Scherr; S F Shariat Journal: Prostate Cancer Prostatic Dis Date: 2016-01-26 Impact factor: 5.554