Hemoglobin, alkalic phosphatase, and C‐reactive protein predict the outcome in patients with liposarcoma

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Recent evidence suggests that common prognostic factors predicting disease progression and survival in soft tissue sarcomas (STS) are not applicable to all STS entities, indicating the need for histotype specific evaluation of new prognosticators. This study aimed at evaluating preoperative serum creatinine, albumin, and the albumin-creatinine ratio (ACR) as markers for survival in patients with malignant fibroblastic and myofibroblastic sarcomas. One hundred and thirty-two patients who underwent sarcoma resection have been included. Statistical analysis comprised uni- and multivariable Cox proportional hazard models, competing risk analysis and Kaplan-Meier estimates. The 5-year overall survival (OS) was estimated at 64.1% (95%CI: 53.7-72.8) and the 5-year sarcoma-specific mortality was 19.9% (95%CI: 12.8-28.1). Elevated serum creatinine levels were significantly associated with an impaired sarcoma-specific survival (SSS) adjusted for tumor stage (subdistribution hazard ratio (SHR) per 1 mg/dl increase: 3.27; 95%CI: 1.87-5.73; p < 0.0001). Low serum albumin levels were associated with a shorter recurrence-free survival (RFS) experience (HR per 10 g/L increase: 0.62; 95%CI: 0.41-0.94; p = 0.024). The ACR emerged as an AJCC-stage-independent prognosticator of SSS (SHR per 1 unit increase: 0.94; 95%CI: 0.90-0.98; p = 0.003). In conclusion, serum albumin and creatinine have been confirmed as predictive biomarkers for disease-specific outcomes in myofibroblastic and fibroblastic sarcomas. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2815-2824, 2017.

Section: Resultsmentioning

confidence: 99%

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confidence: 99%

Serum creatinine and albumin predict sarcoma‐specific survival in patients with myofibroblastic and fibroblastic sarcomas

Willegger

Posch

Schieder

et al. 2017

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“…In recent studies the concept of the involvement of sytemic inflammation, acute phase proteins in cancer progression has been postulated. Specifically, elevated preopeartive CRP and neutrophil/lymphocyte (N/L) ratio as markers of systemic inflammatory response have been found to be associated with decreased overall survival in STS …”

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confidence: 99%

Elevated serum creatinine and low albumin are associated with poor outcomes in patients with liposarcoma

Panotopoulos

Posch

Funovics

et al. 2015

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Low serum albumin levels and impaired kidney function have been associated with decreased survival in patients with a variety of cancer types. In a retrospective cohort study, we analyzed 84 patients with liposarcoma treated at from May 1994 to October 2011. Uni-and multivariable Cox proportional hazard models and competing risk analyses were performed to evaluate the association between putative biomarkers with disease-specific and overall survival. The median age of the study population was 51.7 (range 19.6-83.8) years. In multivariable analysis adjusted for AJCC tumor stage, serum creatinine was highly associated with diseasespecific survival (Subdistribution Hazard ratio (SHR) per 1 mg/dl increase ¼ 2.94; 95%CI 1.39-6.23; p ¼ 0.005). High albumin was associated with improved overall and disease-specific survival (Hazard Ratio (HR) per 10 units increase ¼ 0.50; 95%CI 0.26-0.95; p ¼ 0.033 and SHR ¼ 0.64; 95%CI 0.42-1.00; p ¼ 0.049). The serum albumin-creatinine-ratio emerged to be associated with both overall and disease-specific survival after adjusting for AJCC tumor stage (HR ¼ 0.95; 95%CI 0.92-0.99; p ¼ 0.011 and SHR ¼ 0.96; 95%CI 0.93-0.99; p ¼ 0.08). Our study provides evidence for a tumor-stage-independent association between higher creatinine and lower albumin with worse disease-specific survival. Low albumin and a high albumin-creatinine-ratio independently predict poor overall survival. Our work identified novel prognostic biomarkers for prognosis of patients with liposarcoma. ß

“…Cancer cells may interact directly and indirectly with host inflammatory cells 6, 9, 15. Especially the C‐reactive protein (an acute phase protein synthesized by the liver) as a marker of systemic inflammatory response has been found to be associated with decreased survival rates in different malignancies 5, 7, 8, 16, 17…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, elevated pre‐operative CRP as marker of systemic inflammatory response has been found to be associated with decreased overall survival in osteosarcoma, chordoma, and soft tissue sarcoma 5, 7, 8, 9…”

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confidence: 99%

C‐reactive protein: An independent predictor for dedifferentiated chondrosarcoma

Nemecek

Funovics

Hobusch

et al. 2018

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Dedifferentiated chondrosarcoma is a rare primary bone malignancy with a very poor prognosis. The aim of the study was to identify pretreatment serum markers as prognostic factors for the overall survival (OS) of patients with dedifferentiated chondrosarcoma. We retrospectively reviewed 33 patients with histologically confirmed dedifferentiated chondrosarcoma treated at our department from 1977 to 2015. Kaplan‐Meier estimation, uni‐ and multivariable Cox proportional hazard model were performed to evaluate the association between serum markers such as the C‐reactive protein and OS. In univariable analysis, CRP was strongly associated with OS (HR 1.35; 95%CI 1.13–1.61; p = 0.001). This association prevailed after adjustment for AJCC tumor stage (HR 1.31; 95%CI 1.02–1.57; p = 0.031) in multivariable analysis. In conclusion, our data gave evidence that baseline CRP is an independent predictor for OS in patients with dedifferentiated chondrosarcoma. CRP could be exploited for the clinical prediction of this disease in the future. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 36:2797–2801, 2018.