Evaluation of a cumulative prognostic score based on the systemic inflammatory response in patients undergoing potentially curative surgery for colorectal cancer

Canna, Khalid; McMillan, Donald C.; McKee, Ruth F.; McNicol, A. M.; Horgan, Paul G.; McArdle, C. S.

doi:10.1038/sj.bjc.6601757

Cited by 60 publications

(50 citation statements)

References 12 publications

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“…Indeed, this approach has recently been used to improve the prediction of outcome in patients who underwent potentially curative resection for oesophageal and colorectal cancer (Ikeda et al, 2003;Canna et al, 2004). In the present study, an elevated C-reactive protein concentration, measured either pre-or postoperatively, was associated with more than a halving of survival.…”

Section: Discussionmentioning

confidence: 55%

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

et al. 2004

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The aim of the present study was to examine the relationship between the clinicopathological status, the pre-and postoperative systemic inflammatory response and survival in patients undergoing potentially curative resection for ductal adenocarcinoma of the head of the pancreas. Patients (n ¼ 65) who underwent resection of ductal adenocarcinoma of the head of pancreas between 1993 and 2001, and had pre-and postoperative measurements of C-reactive protein, were included in the study. The majority of patients had stage III disease (International Union Against Cancer Criteria, IUCC), positive circumferential margin involvement (R 1 ), tumour size greater than 25 mm with perineural and lymph node invasion and died within the follow-up period. On multivariate analysis, tumour size (hazard ratio (HR) 2.10, 95% confidence interval (CI) 1.20 -3.68, P ¼ 0.009), vascular invasion (HR 2.58, 95% CI 1.48 -4.50, Po0.001) and postoperative C-reactive protein (HR 2.00, 95% CI 1.14 -3.52, P ¼ 0.015) retained independent significance. Those patients with a postoperative C-reactive protein p10 mg l À1 had a median survival of 21.5 months compared with 8.4 months in those patients with a C-reactive protein 410 mg l À1 (Po0.001). The results of the present study indicate that, in patients who have undergone potentially curative resection for ductal adenocarcinoma of the head of pancreas, the presence of a systemic inflammatory response predicts poor outcome.

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Section: Discussionmentioning

confidence: 55%

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

et al. 2004

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“…Nevertheless, taken together, these results show the utility of C-reactive protein in the preoperative assessment of patients undergoing potentially curative surgery for GI cancer. Indeed, the combination of pathological stage and C-reactive protein has recently been used to improve the prediction of outcome in patients who underwent potentially curative resection for colorectal cancer (Canna et al, 2004). The basis of the independent relationship between an elevated C-reactive protein concentration and poor survival in gastrooesophageal cancer is not clear.…”

Section: Discussionmentioning

confidence: 99%

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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“…Indeed, this approach has recently been used in both lung and colorectal cancer (Forrest et al, 2003;Canna et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

The relationship between the systemic inflammatory response and survival in patients with transitional cell carcinoma of the urinary bladder

et al. 2005

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The relationship between tumour stage, grade, elevated C-reactive protein concentration (o10/410 mg l À1 ), adjuvant therapy and survival was examined in patients with biopsy proven bladder cancer (n ¼ 105). On multivariate analysis stage (HR 3.37, 95% CI 1.37 -8.29, P ¼ 0.008), grade (HR 2.01, 95% CI 1.14 -3.57, P ¼ 0.017) and preoperative C-reactive protein (HR 3.31, 95% CI 1.09 -10.09, P ¼ 0.035) were independently associated with cancer-specific survival.

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Evaluation of a cumulative prognostic score based on the systemic inflammatory response in patients undergoing potentially curative surgery for colorectal cancer

Cited by 60 publications

References 12 publications

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

Systemic inflammatory response predicts outcome in patients undergoing resection for ductal adenocarcinoma head of pancreas

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

The relationship between the systemic inflammatory response and survival in patients with transitional cell carcinoma of the urinary bladder

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