Influence of Inflammation-Based Prognostic Score on Mortality of Patients Undergoing Chemotherapy for Far Advanced or Recurrent Unresectable Colorectal Cancer

Ishizuka, Mitsuru; Nagata, Hitoshi; Takagi, Kazutoshi; Kubota, Keiichi

doi:10.1097/sla.0b013e3181b16e24

Cited by 94 publications

(68 citation statements)

References 31 publications

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“…As regards the connection between the high serum concentration of CRP and other inflammatory markers found earlier by many groups (Allin et al 2009;Ishizuka et al 2009;Koike et al 2008;Nozoe et al 2008;Wang and Sun 2009), several possible explanations were suggested. Acute phase proteins (APPs) are produced and release into circulation predominantly by the hepatocytes due to inflammation, tissue destruction (e.g., trauma, myocardial infarction) infections, or cancer.…”

Section: Discussionmentioning

confidence: 99%

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High levels of acute phase proteins and soluble 70 kDa heat shock proteins are independent and additive risk factors for mortality in colorectal cancer

Kocsis

Mészáros

Madaras

et al. 2011

Cell Stress and Chaperones

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Recently, we reported that high soluble Hsp70 (sHsp70) level was a significant predictor of mortality during an almost 3-year-long follow-up period in patients with colorectal cancer. This association was the strongest in the group of <70-year-old female patients as well as in those who were in a less advanced stage of the disease at baseline. According to these observations, measurement of the serum level of sHsp70 is a useful, stage-independent prognostic marker in colorectal cancer, especially in patients without distant metastasis. Since many literature data indicated that measurement of C-reactive protein (CRP) and other acute phase proteins (APPs) may also be suitable for predicting the mortality of patients with colorectal cancer, it seemed reasonable to study whether the effect of sHsp70 and other APPs are related or independent. In order to answer this question, we measured the concentrations of CRP as well as of other complement-related APPs (C1 inhibitor, C3, and C9) along with that of the MASP-2 complement component in the sera of 175 patients with colorectal cancer and known levels of sHsp70, which have been used in our previous study. High (above median) levels of CRP, C1 esterase inhibitor (C1-INH), and sHsp70 were found to be independently associated with poor patient survival, whereas no such association was observed with the other proteins tested. According to the adjusted Cox proportional hazards analysis, the additive effect of high sHsp70, CRP, and C1-INH levels on the survival of patients exceeded that of high sHsp70 alone, with a hazard ratio (HR) of 2.83 (1.13-70.9). In some subgroups of patients, such as in females )] or in ≤70-year-old patients )], even greater differences were obtained. These findings indicate that the clinical mortality-prediction value of combined measurements of sHsp70, CRP, and C1-INH with inexpensive methods can be very high, especially in specific subgroups of patients with colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

“…The predictive value of CRP was found to be independent of CEA levels (Koike et al 2008). Moreover, not only CRP but also different scores derived from inflammatory markers were found strongly related to the survival of patients with colorectal cancer (Ishizuka et al 2009). …”

Section: Introductionmentioning

confidence: 99%

High levels of acute phase proteins and soluble 70 kDa heat shock proteins are independent and additive risk factors for mortality in colorectal cancer

Kocsis

Mészáros

Madaras

et al. 2011

Cell Stress and Chaperones

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“…Among various hematological factors including biomarkers for systemic inflammation such as C-reactive protein and albumin, we first identified predictors of prognosis of patients undergoing pre-operative chemotherapy. In this study, a C-reactive protein concentration >1.0 mg/dl and albumin level <3.5 mg/dl were considered to reflect the presence of systemic inflammation, based on previous studies (9,(12)(13)(14). Upon univariate analysis, the leucocyte count, hemoglobin, albumin level and CEA were significantly associated with survival, while the serum concentration of C-reactive protein was not (Table II and Fig.…”

Section: Patient Population From April 2000 To September 2008 385 Pmentioning

confidence: 93%

“…Hypoalbuminemia is sometimes used in combination with elevated C-reactive protein to calculate the inflammation-based prognostic score, Glasgow Prognostic score. The Glasgow Prognostic score is reported to be useful in predicting survival of patients with colorectal cancers, nonsmall cell lung cancers, pancreatic cancers and breast cancers (12)(13)(14). In esophageal cancers, Crumley et al (34) demonstrated that the Glasgow Prognostic score predicts cancer-specific survival of patients with inoperable gastroesophageal cancers.…”

Section: Discussionmentioning

confidence: 99%

“…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 shown that serum C-reactive protein as a biomarker of systemic inflammation is useful for predicting the prognosis of patients undergoing esophagectomy (15-18).…”

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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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Prognostic Significance of Tumor-Infiltrating Lymphocytes for Patients With Colorectal Cancer

Lee¹

2012

Arch Surg

146

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Influence of Inflammation-Based Prognostic Score on Mortality of Patients Undergoing Chemotherapy for Far Advanced or Recurrent Unresectable Colorectal Cancer

Abstract: mGPS is an important and independent predictor of mortality in patients undergoing chemotherapy for AR-UCRC.

Cited by 94 publications

References 31 publications

High levels of acute phase proteins and soluble 70 kDa heat shock proteins are independent and additive risk factors for mortality in colorectal cancer

High levels of acute phase proteins and soluble 70 kDa heat shock proteins are independent and additive risk factors for mortality in colorectal cancer

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

Prognostic Significance of Tumor-Infiltrating Lymphocytes for Patients With Colorectal Cancer

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