Elevation of preoperative serum C‐reactive protein level is related to poor prognosis in esophageal squamous cell carcinoma

Shimada, Hideaki; Nabeya, Yoshihiro; Okazumi, Shinichi; Matsubara, Hisahiro; Shiratori, Tooru; Aoki, Taito; Sugaya, Makoto; Miyazawa, Yasumasa; Hayashi, Hideki; Miyazaki, Shinichi; Ochiai, Takenori

doi:10.1002/jso.10275

Cited by 134 publications

(125 citation statements)

References 27 publications

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“…Therefore, the results of the present study are consistent with C-reactive protein, measured before surgery, having prognostic value independent of established pathological criteria in patients with resectable oesophageal cancer (Nozoe et al, 2001;Ikeda et al, 2003;Shimada et al, 2003). Moreover, we have shown that an elevated C-reactive protein concentration, before surgery, is associated with poor cancer-specific survival in patients undergoing potentially curative resection for gastro-oesophageal adenocarcinoma.…”

Section: Discussionsupporting

confidence: 89%

“…There have been three previous studies from Japan that have shown the prognostic value of an elevated C-reactive protein concentration in patients undergoing resection for oesophageal cancer. However, in contrast with the present study, they included patients with primarily (490%) squamous tumours (Nozoe et al, 2001;Ikeda et al, 2003;Shimada et al, 2003), patients receiving neo-adjuvant treatment (Nozoe et al, 2001;Ikeda et al, 2003), patients who had advanced disease before surgery (Nozoe et al, 2001;Ikeda et al, 2003), they used a threshold for C-reactive protein of 45 mg l À1 (Nozoe et al, 2001;Ikeda et al, 2003) and the positive to total lymph node ratio was not assessed (Nozoe et al, 2001;Ikeda et al, 2003;Shimada et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…An elevated serum C-reactive protein concentration, before surgery, has previously been shown to have independent prognostic value in patients with resectable oesophageal cancer (Nozoe et al, 2001;Ikeda et al, 2003;Shimada et al, 2003). However, some of these studies included patients with metastatic disease at the time of surgery and used variable C-reactive protein thresholds.…”

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confidence: 99%

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An elevated C-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer

et al. 2006

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There is increasing evidence that the presence of an ongoing systemic inflammatory response is associated with poor outcome in patients undergoing resection for a variety of tumours. The aim of the present study was to examine the relationship between clinicopathological status, preoperative C-reactive protein concentration and cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer. One hundred and twenty patients attending the upper gastrointestinal surgical unit in the Royal Infirmary, Glasgow, who were selected for potentially curative surgery, were included in the study. Laboratory measurements of haemoglobin, white cell, lymphocyte and platelet counts, albumin and C-reactive protein were carried out at the time of diagnosis. All patients underwent en-bloc resection with lymphadenectomy and survived at least 30 days following surgery. On multivariate analysis, only the positive to total lymph node ratio (hazard ratio (HR) 2.02, 95% confidence interval (CI) 1.44 -2.84, Po0.001) and preoperative C-reactive protein concentration (HR 3.53, 95% CI 1.88 -6.64, Po0.001) were independent predictors of cancer-specific survival. The patient group with no evidence of a preoperative systemic inflammatory response (C-reactive protein p10 mg l À1 ) had a median survival of 79 months compared with 19 months in the elevated systemic inflammatory response group (Po0.001). The results of the present study indicate that in patients selected to undergo potentially curative resection for gastro-oesophageal cancer, the presence of an elevated preoperative C-reactive protein concentration is an independent predictor of poor cancer-specific survival.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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An elevated C-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer

et al. 2006

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“…Alterations of serum CRP is a common feature in patients with malignancies which has been found to be adversely prognostic, with patients having elevated CRP levels (Nozoe et al, 1998;Nakanishi et al, 2002;Shimada et al, 2003;Hashimoto et al, 2005). Growing evidence suggests prognostic importance because increased CRP levels are associated with the production of cytokines from tumour cells (Kurzrock, 1997;Legouffe et al, 1998, Yamamura et al, 1998.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the prognostic value of baseline biological markers including high levels of b2-microglobulin (B2-M), lactate dehydrogenase (LDH), and serum albumin (Bataille et al, 1992), elevations of serum C-reactive protein (CRP) have been consistently associated with a poor prognosis in myeloma (Tienhaara et al, 1994;Kaneko et al, 2002;Terpos et al, 2003). Several studies regarding the role of preoperative CRP as a predictive indicator for the malignant potential and prognosis in various other cancers have been published (Nozoe et al, 1998;Nakanishi et al, 2002;Shimada et al, 2003;Hashimoto et al, 2005). However, the prognostic significance based on preoperative CRP has not been clarified for myeloma patients, yet.…”

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confidence: 99%

Preoperative elevation of serum C – reactive protein is predictive for prognosis in myeloma bone disease after surgery

et al. 2006

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We investigated whether preoperative levels of serum C-reactive protein (CRP) and its correlation with tumour clinicopathological findings adds prognostic information beyond the time of diagnosis in patients with myeloma bone disease (MM) to facilitate the surgical decision-making process. Six hundred and fifty-eight myeloma patients were evaluated retrospectively for surgery. Clinicopathological variables of patients who underwent surgery (n ¼ 71) were compared between patients with preoperative CRP X6 mg l À1 and those with CRP o6 mg l À1 . Univariate and multivariate analyses were performed to identify prognostic factors after surgery. Patients with an increase of CRP prior to surgery showed inferior survival compared to patients with normal levels. Patients with normal CRP levels at diagnosis but elevations prior to surgery do seem to have a similar unfavourable overall survival (OS) than patients with an increase both, at diagnosis and at surgery. Conversely, patients with normal CRP levels prior to surgery still have the best OS, irrespective of their basic values. Multivariate analysis revealed preoperative CRP levels above 6 mg l À1 Lactate dehydrogenase (LDH) above normal, and osteolyses in long weight bearing bones as independent predictors of survival. These findings suggest that in patients with MM serum levels of CRP increase during disease activity and might be significantly correlated with specific disease characteristics including adverse prognostic features such as osteolyses in long weight bearing bones. Thus, preoperative elevated CRP serum levels might be considered as independent predictor of prognosis and could provide additional prognostic information for the risk stratification before surgical treatment in patients with myeloma bone disease.

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Clinical prognostic scoring system to aid decision-making in gastro-oesophageal cancer

Deans

Wigmore

Beaux

et al. 2007

British Journal of Surgery

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Elevation of preoperative serum C‐reactive protein level is related to poor prognosis in esophageal squamous cell carcinoma

Abstract: A high CRP level is associated with tumor progression and poor survival in patients with esophageal squamous cell carcinoma.

Cited by 134 publications

References 27 publications

An elevated C-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer

An elevated C-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer

Preoperative elevation of serum C – reactive protein is predictive for prognosis in myeloma bone disease after surgery

Clinical prognostic scoring system to aid decision-making in gastro-oesophageal cancer

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