Association of C-Reactive Protein Levels and Long-Term Survival after Neoadjuvant Therapy and Esophagectomy for Esophageal Cancer

Zingg, Urs; Forberger, Jens; Rajcic, Branimir; Langton, Christopher; Jamieson, Glyn G.

doi:10.1007/s11605-009-1113-2

Cited by 37 publications

(44 citation statements)

References 35 publications

(45 reference statements)

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“…For example, C-reactive protein concentration has been reported to predict survival in esophageal cancer patients. 38,[46][47][48] However, C-reactive protein tests are not routinely available in many hospitals. In contrast, NLR and PLR tests are easy to perform, less expensive, and readily available.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis

et al. 2015

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“…C-reactive protein is produced in the liver and its production is regulated by pro-inflammatory cytokines such as interleukin (IL)-6, IL-1 and tumor necrosis factor (TNF)α (26)(27)(28). Several previous studies demonstrated that a pre-operative high C-reactive protein level was inversely correlated with survival of patients with esophageal cancer (15)(16)(17)(18). In these studies, the cutoff value of C-reactive protein ranged from 0.5 to 1.0 mg/dl.…”

Section: Discussionmentioning

confidence: 99%

“…Low serum albumin concentration, often in combination with elevated C-reactive protein, is reported to be a predictor of poor prognosis in various types of cancers including colorectal cancers (12)(13)(14). In esophageal cancers, previous studies have also shown that serum C-reactive protein as a biomarker of systemic inflammation is useful for predicting the prognosis of patients undergoing esophagectomy (15)(16)(17)(18). However, whether such serum biomarkers correlate with the outcome of pre-operative therapy and survival of patients undergoing multimodal treatment is not clear at present.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of an inflammation-based score in patients undergoing pre-operative chemotherapy followed by surgery for esophageal cancer

Miyata

Yamasaki

Kurokawa

et al. 2011

Experimental and Therapeutic Medicine

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Abstract.Recent studies have shown that the presence of systemic inflammation is associated with poor outcome in patients with malignancy. However, whether systemic inflammation affects the response to pre-operative therapy and survival of patients undergoing multimodal treatment for esophageal cancer is not clear. We studied 152 patients who underwent pre-operative chemotherapy followed by surgery for esophageal cancer. The correlation between various clinico pathological factors, including hematological markers of systemic inflammatory response, and survival or response to chemotherapy was examined. Among various hematological factors, leucocyte count, hemoglobin level, albumin level, neutrophil-lymphocyte ratio and CEA, but not serum concentration of C-reactive protein, were significantly associated with survival. Multivariate analysis revealed that the clinical response to chemotherapy, number of metastatic lymph nodes, operative complications and systemic inflammation score (SI score), comprising leucocyte count, albumin and hemoglobin levels, were independent prognostic factors, and identified the SI score as the most significant prognostic factor. There was no significant relationship between hematological markers of systemic inflammation, including the SI score, and the response to chemotherapy. In conclusion, in patients scheduled for chemotherapy followed by surgery for esophageal cancer, systemic inflammation, reflected by SI, predicts poor outcome, but not the response to chemotherapy. IntroductionEsophagectomy is the standard treatment for esophageal cancer. However, the majority of patients who undergo curative resection subsequently develop local or systemic recurrence, and the 5-year survival rate ranges from 15 to 39% (1,2). To improve prognosis, the combination of peri-operative chemotherapy and/or radiotherapy is used in conjunction with esophagectomy. Neoadjuvant chemoradiotherapy followed by surgery is one of the most promising strategies for advanced esophageal cancers, and several studies have reported survival advantages of this trimodality therapy compared with surgery alone (3-5). Another potential combination therapy is neoadjuvant chemotherapy followed by surgery, and several studies have reported encouraging results (6-8). Thus, multimodal treatment combining surgery with other treatments has achieved mainstream status as a curative therapy for advanced esophageal cancer.Recently, there is increasing evidence that a systemic inflammatory response is of prognostic value in patients with various types of cancers. Elevated serum C-reactive protein concentration is associated with poor prognosis in colorectal, breast and ovarian cancers (9-11). Another commonly used biomarker for systemic inflammation is serum albumin concentration. Low serum albumin concentration, often in combination with elevated C-reactive protein, is reported to be a predictor of poor prognosis in various types of cancers including colorectal cancers (12)(13)(14). In esophageal cancers, previous studies have also sh...

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“…In patients that underwent neoadjuvant therapy followed by esophagectomy, patients with normal CRP levels had a significant survival advantage compared to patient with an elevated CRP (median survival 65.4 moths and 5-year survival 52.1% compared to median survival 18.7 months vs 5-year survival 23.3%, p=0.027). (Zingg, Forberger, Rajcic, Langton, & Jamieson 2010) Data for other acute phase proteins in esophageal cancer is limited. An et al showed in a small study that SAA and HAP were elevated in patients with esophageal cancer.…”

Section: Acute Phase Proteins In Cancermentioning

confidence: 99%

Acute Phase Proteins as Cancer Biomarkers

Orr¹,

Malkas²,

Hickey³

et al. 2011

Acute Phase Proteins as Early Non-Specific Biomarkers of Human and Veterinary Diseases

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Association of C-Reactive Protein Levels and Long-Term Survival after Neoadjuvant Therapy and Esophagectomy for Esophageal Cancer

Abstract: Preoperative CRP levels are an independent prognostic marker for survival after neoadjuvant treatment in patients with esophageal cancer and may be of value in the re-staging process after neoadjuvant treatment.

Cited by 37 publications

References 35 publications

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Oncologic Outcomes of Esophageal Cancer: A Systematic Review and Meta-analysis

Prognostic value of an inflammation-based score in patients undergoing pre-operative chemotherapy followed by surgery for esophageal cancer

Acute Phase Proteins as Cancer Biomarkers

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