High CRP values predict poor survival in patients with penile cancer

Steffens, Sandra; Ghazal, Andreas Al; Steinestel, Julie; Lehmann, Rieke; Wegener, Gerd; Schnoeller, Thomas; Cronauer, Marcus V.; Jentzmik, Florian; Schrader, Mark; Kuczyk, Markus A.; Schrader, Andres Jan

doi:10.1186/1471-2407-13-223

Cited by 38 publications

(31 citation statements)

References 30 publications

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“…C-reactive protein is an acute-phase reactant that responds to the tumour microenvironment, causing tumour cell death and local tissue damage [25], and high levels of this protein have been linked to cancer risk and/or progression in various malignancies [13][14][15]. In the present study, elevated CRP levels were associated with progressive tumour characteristics, including ENE (P < 0.001), pelvic LNM (P = 0.007), pathological tumour status (P = 0.002), and pathological nodal status (P < 0.001; Table 2), consistent with several previous studies [16,17]. Because these pathological characteristics are of utmost prognostic importance in penile carcinoma [1][2][3]22,23], an elevated CRP level may be predictive of more aggressive and progressive disease [16,17].…”

Section: Discussionsupporting

confidence: 92%

“…Elevated CRP levels before surgery can serve as a diagnostic marker and a marker of poor prognosis in penile cancer [16,17]. Similarly, several studies have shown that SCC-Ag level, which might also serve as a sensitive marker of disease progression, is correlated with tumour burden in penile cancer [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…An elevated CRP concentration is independently correlated with tumour load and disease progression, which is also correlated with survival in various cancers [14,15], and two recent studies have shown that CRP correlates with tumour burden in penile cancer [16,17]. Another potential prognostic marker in penile cancer is SCC antigen (SCC-Ag), a serum tumour marker used for various human SCCs [18,19], and an elevated level of SCC-Ag has been reported to be associated with clinical outcome in patients with penile cancer [19][20][21]; however, to the best of our knowledge, the relationship between CRP and SCC-Ag levels and their potential value in combination as a prognostic marker of survival in penile cancer have not been previously explored.…”

Section: Introductionmentioning

confidence: 99%

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Clinical significance of preoperative C‐reactive protein and squamous cell carcinoma antigen levels in patients with penile squamous cell carcinoma

Yao

et al. 2015

BJU International

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ObjectiveTo evaluate the relevance of C-reactive protein (CRP) and squamous cell carcinoma antigen (SCC-Ag) levels in relation to clinicopathological factors and prognosis in penile cancer. Patients and MethodsA total of 124 Chinese patients with penile squamous cell carcinoma (SCC), treated between November 2007 and October 2014, were analysed retrospectively. Receiveroperating characteristic curves were used to identify the combination of markers with the best sensitivity and specificity for prognosis prediction. Statistical data analysis was performed using a non-parametric method, and survival analysis was performed using the log-rank test and Cox proportional hazard model. ResultsLevels of CRP ≥4.5 mg/L and SCC-Ag ≥1.4 ng/mL were both significantly associated with lymph node metastasis (LNM) laterality (chi-squared trend test, P = 0.041), extranodal extension (chi-squared trend test, P < 0.001), pelvic LNM (chi-squared trend test, P = 0.024), pathological tumour status (chi-squared trend test, P = 0.002), pathological nodal status (chi-squared trend test, P < 0.001), and diseasespecific survival (DSS; log-rank test, P < 0.001). Moreover, the influence of CRP and SCC-Ag levels on DSS (P = 0.033, hazard ratio 3.390, 95% confidence interval 1.104-10.411) remained after adjusting for smoking history, phimosis, tumour status, tumour cell differentiation and nodal status. ConclusionsThe present study shows that the combined measurement of preoperative CRP and SCC-Ag levels may serve as an independent biomarker for LNM, advanced tumour stage and DSS in patients with penile SCC.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical significance of preoperative C‐reactive protein and squamous cell carcinoma antigen levels in patients with penile squamous cell carcinoma

Yao

et al. 2015

BJU International

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“…Therefore, CRP may indicate inflammation. Previous studies have demonstrated that an increased level of CRP may be associated with poorer prognosis in patients with tumors, including ovarian cancer, penile cancer and non-small cell lung cancer (36)(37)(38). In addition, malabsorption and malnutrition may be associated with decreased survival time in various tumors, including esophageal squamous cell carcinomas and endometrial cancer (39,40).…”

Section: Discussionmentioning

confidence: 99%

C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

et al. 2017

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Abstract. Multiple studies have reported the prognostic association of certain inflammatory factors with various types of cancer. The present study assessed the prognostic value of the C-reactive protein (CRP)/albumin (Alb) ratio and the neutrophil/lymphocyte ratio (NLR), separately and in combination, in gastric cancer (GC). A total of 337 cases pathologically diagnosed with gastric adenocarcinoma were retrospectively evaluated. The clinicopathological and prognostic relevance of the CRP/Alb ratio and NLR and their combination were analyzed. The optimal cut-off values of the CRP/Alb ratio and NLR were 0.38 and 3.14, respectively. High CRP/Alb ratio (≥0.38) and NLR (≥3.14) values were associated with increased tumor invasion, more distant metastasis and a more advanced tumor-node-metastasis stage (all P<0.05). In addition, a high NLR value was also associated with increased tumor size (P= 0.02). The CRP/Alb ratio (≥0.38/<0.38) and NLR (≥3.14/<3.14) were independent prognostic factors for overall survival time (OS) in GC by multivariate analysis (P= 0.005 and P= 0.001). Using the CRP/Alb ratio and NLR classification, patients were stratified into three subgroups with different OS time (P<0.001), which were identified as independent prognostic variables in multivariate analysis (P<0.001). The present study demonstrated that the CRP/Alb ratio and NLR were independent prognostic factors for OS in patients with GC. The combination of these indexes was associated with significant prognostic value and may further stratify prognosis. IntroductionGastric cancer (GC) is one of the most common types of tumor globally. In 2015, GC had the second highest incidence and rate of mortality among cancer patients in China (1). Due to the rapid progression of GC and the absence of early specific symptoms and signs, the majority of patients are diagnosed at the late stage of gastric carcinoma (2-5). At present, surgery is the preferred treatment for patients without distant metastasis, and postoperative metastasis and recurrence are the predominant causes of mortality (3,5). Although disease-free and overall survival (OS) may be improved by postoperative chemotherapy and radiotherapy, the prognosis of GC remains poor (3,6). Identifying simple but effective prognostic markers for GC remains an important aim for researchers.Inflammation occurs in various types of tumor, and serves a crucial function in tumor development and distant metastasis (7-10). Previous studies have indicated that inflammation is associated with the formation of the tumor microenvironment by inflammatory mediators, including vasoactive amines and cytokines (11-13). The C-reactive protein (CRP)/albumin (Alb) ratio is used as a novel inflammation-based prognostic indicator in multiple types of tumor. Previous studies have demonstrated the prognostic value of CRP/Alb ratio in colorectal (14) and esophageal cancer (15), hepatocellular carcinoma (16), and renal (17) and pancreatic cancer (18). Another important inflammatory marker is the neutrophil/lymphocyte ratio (...

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“…Elevated C-reactive protein (CRP) has been reported to be associated with nodal metastasis and poorer cancerspecific survival (CSS) [9,10], and a high neutrophillymphocyte ratio (NLR) has also been shown to predict poor CSS in patients with penile cancer [11]. Another potential biomarker, the absolute lymphocyte count-absolute monocyte count ratio (LMR) has been shown to be able to predict clinical outcomes of patients with cancer, including colorectal cancer, sarcoma and lymphoid neoplasms [12][13][14].…”

Section: Introductionmentioning

confidence: 99%