Woo Ram Kim1,2, Yoon Dae Han2, Byung Soh Min3. 1. Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi, Korea. 2. Department of Surgery, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. 3. Department of Surgery, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. BSMIN@yuhs.ac.
Abstract
BACKGROUND: Systemic inflammatory response, as measured by C-reactive protein (CRP), is associated with prognosis in various types of human malignancies. However, to the best of our knowledge, the clinical significance of CRP in patients with locally advanced rectal cancer that undergo preoperative chemoradiation has not been investigated in detail. This retrospective study validates CRP as a potential predictive marker for survival outcomes in rectal cancer patients. METHODS: In this study, we enrolled 125 patients that received total mesorectal excision after preoperative chemoradiation for rectal cancer between January 2003 and December 2010. We investigated the association between preoperative CRP and clinicopathological characteristics and assessed the prognostic value of CRP. RESULTS: The median follow-up was 41 months. Elevated CRP showed significant correlation with high histological grade (P = 0.009) and cancer recurrence (P = 0.027). The 5-year disease-free survival and cancer-specific survival were significantly lower in the elevated CRP group (P = 0.001). Moreover, CRP was the strongest predictive factor for cancer-specific survival in multivariate analysis (P = 0.001). In the subgroup analysis, elevated CRP was a significant prognostic factor in patients with node-positive disease (P = 0.025) and was associated with poorer tumor regression (TRG4-5; P = 0.011). CONCLUSIONS: The results of our study suggest that preoperative CRP level shows prognostic significance in rectal cancer patients that have undergone chemoradiation. Therefore, preoperative CRP may help clinicians to identify patients that need additional therapy to reduce systemic failure.
BACKGROUND: Systemic inflammatory response, as measured by C-reactive protein (CRP), is associated with prognosis in various types of humanmalignancies. However, to the best of our knowledge, the clinical significance of CRP in patients with locally advanced rectal cancer that undergo preoperative chemoradiation has not been investigated in detail. This retrospective study validates CRP as a potential predictive marker for survival outcomes in rectal cancerpatients. METHODS: In this study, we enrolled 125 patients that received total mesorectal excision after preoperative chemoradiation for rectal cancer between January 2003 and December 2010. We investigated the association between preoperative CRP and clinicopathological characteristics and assessed the prognostic value of CRP. RESULTS: The median follow-up was 41 months. Elevated CRP showed significant correlation with high histological grade (P = 0.009) and cancer recurrence (P = 0.027). The 5-year disease-free survival and cancer-specific survival were significantly lower in the elevated CRP group (P = 0.001). Moreover, CRP was the strongest predictive factor for cancer-specific survival in multivariate analysis (P = 0.001). In the subgroup analysis, elevated CRP was a significant prognostic factor in patients with node-positive disease (P = 0.025) and was associated with poorer tumor regression (TRG4-5; P = 0.011). CONCLUSIONS: The results of our study suggest that preoperative CRP level shows prognostic significance in rectal cancerpatients that have undergone chemoradiation. Therefore, preoperative CRP may help clinicians to identify patients that need additional therapy to reduce systemic failure.
Authors: Florian Primavesi; Valentina Andreasi; Frederik J H Hoogwater; Stefano Partelli; Dominik Wiese; Charlotte Heidsma; Benno Cardini; Eckhard Klieser; Katharina Marsoner; Uwe Fröschl; Sabine Thalhammer; Ines Fischer; Georg Göbel; Andreas Hauer; Tobias Kiesslich; Philipp Ellmerer; Reinhold Klug; Daniel Neureiter; Helwig Wundsam; Franz Sellner; Peter Kornprat; Reinhold Függer; Dietmar Öfner; Elisabeth J M Nieveen van Dijkum; Detlef K Bartsch; Ruben H J de Kleine; Massimo Falconi; Stefan Stättner Journal: Cancers (Basel) Date: 2020-05-14 Impact factor: 6.639
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