Julie N Graff1, Tomasz M Beer2, Bian Liu3, Guru Sonpavde4, Emanuela Taioli5. 1. Portland VA Medical Center, Portland, OR; Knight Cancer Institute, Oregon Health and Science University, Portland, OR. 2. Knight Cancer Institute, Oregon Health and Science University, Portland, OR. 3. Hofstra North Shore-LIJ School of Medicine; The Feinstein Institute for Medical Research, Manhasset, NY. 4. University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL. 5. Hofstra North Shore-LIJ School of Medicine; The Feinstein Institute for Medical Research, Manhasset, NY. Electronic address: taiolema@gmail.com.
Abstract
INTRODUCTION: Previous studies have reported that higher C-reactive protein (CRP) levels are significantly associated with worse outcome in prostate cancer patients. The size of each individual study was not large enough to allow sufficient statistical power to draw conclusions. We conducted a pooled analysis of individual data of published studies to evaluate the association between increased CRP level and risk of death in prostate cancer, and to find the best CRP cutoff that could predict mortality. MATERIALS AND METHODS: Original research studies on prostate cancer survival and CRP levels were identified (n = 6). Corresponding authors were contacted and invited to share individual data. Two data sets were received (235 patients). The combined hazard ratio (HR) was calculated and adjusted for age, prostate-specific antigen, hemoglobin, and alkaline phosphatase. The best cutoff of CRP was explored using X-title software version 3.6.1. RESULTS: High CRP level was statistically significantly associated with mortality (meta-HR, 1.83 [95% confidence interval (CI), 1.51-2.21]), without evidence of heterogeneity among studies. At pooled analysis, adjusted pooled HR for CRP < 5 versus ≥ 5 mg/L was 1.44 (95% CI, 1.02-20.4). The best CRP cutoff was 12 mg/L: the adjusted HRpooled for CRP < 12 versus ≥ 12 mg/L was 1.53 (95% CI, 1.01-2.32). CONCLUSION: Increased CRP levels are associated with overall survival in prostate cancer patients. Because CRP is an affordable and readily available assay, it might hold promise in improving prognostication and potentially to predict the activity of specific therapeutic agents.
INTRODUCTION: Previous studies have reported that higher C-reactive protein (CRP) levels are significantly associated with worse outcome in prostate cancerpatients. The size of each individual study was not large enough to allow sufficient statistical power to draw conclusions. We conducted a pooled analysis of individual data of published studies to evaluate the association between increased CRP level and risk of death in prostate cancer, and to find the best CRP cutoff that could predict mortality. MATERIALS AND METHODS: Original research studies on prostate cancer survival and CRP levels were identified (n = 6). Corresponding authors were contacted and invited to share individual data. Two data sets were received (235 patients). The combined hazard ratio (HR) was calculated and adjusted for age, prostate-specific antigen, hemoglobin, and alkaline phosphatase. The best cutoff of CRP was explored using X-title software version 3.6.1. RESULTS: High CRP level was statistically significantly associated with mortality (meta-HR, 1.83 [95% confidence interval (CI), 1.51-2.21]), without evidence of heterogeneity among studies. At pooled analysis, adjusted pooled HR for CRP < 5 versus ≥ 5 mg/L was 1.44 (95% CI, 1.02-20.4). The best CRP cutoff was 12 mg/L: the adjusted HRpooled for CRP < 12 versus ≥ 12 mg/L was 1.53 (95% CI, 1.01-2.32). CONCLUSION: Increased CRP levels are associated with overall survival in prostate cancerpatients. Because CRP is an affordable and readily available assay, it might hold promise in improving prognostication and potentially to predict the activity of specific therapeutic agents.
Authors: Antonella Zucchetto; Andrea Gini; Nitin Shivappa; James R Hébert; Carmen Stocco; Luigino Dal Maso; Silvia Birri; Diego Serraino; Jerry Polesel Journal: Int J Cancer Date: 2016-06-11 Impact factor: 7.396
Authors: Adriana C Vidal; Lauren E Howard; Amanda de Hoedt; Matthew R Cooperberg; Christopher J Kane; William J Aronson; Martha K Terris; Christopher L Amling; Emanuela Taioli; Jay H Fowke; Stephen J Freedland Journal: Cancer Causes Control Date: 2018-04-17 Impact factor: 2.506
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