Prognostic Value of the Doubling Time of Serum C‐reactive Protein and Alkaline Phosphatase Levels in Primary Bone and Soft Tissue Tumors

Abstract

We investigated the clinical relevance of doubling time (DT) of serum laboratory data obtained in routine clinical examination of patients with primary bone and soft tissue tumors, in comparison with major clinical and pathological parameters (age at presentation, sex, tumor size, location, clinical stage and histologic grade) by uni‐ and multivariate analyses. In 64 patients with primary bone and soft tissue tumors (primary bone tumors: 39, primary soft tissue tumors: 25) and 68 cancer patients, the pretreatment DT values of serum C‐reactive protein (CRP), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), calcium (Ca), phosphate (P) levels were measured, as well as the erythrocyte sedimentation rate (ESR: mm/60 min); these values were then compared with overall survival, local recurrence‐free survival and metastasis‐free survival. Only DT of CRP and ALP (CRP‐DT, ALP‐DT) were found to be correlated with disease outcome in patients with primary bone and soft tissue tumors. In cancer patients, only CRP‐DT showed a relation with clinical stage and histologic grade, but the ALP‐DT in patients with bone metastasis was significantly shorter than that in patients with metastases at other sites or in those with no metastasis. Among all tumor patients, those with bone metastasis showed the shortest ALP‐DT compared with those with lung, liver and brain metastasis. Univariate analysis showed that shorter CRP‐DT and ALP‐DT are associated with poor overall survival, and the development of local recurrence and metastasis. These findings suggest that pretreatment CRP‐ and ALP‐DT could be additional prognostic parameters for disease outcome in patients with primary malignant bone and soft tissue tumors. However, in multivariate analysis, only ALP‐DT, but not CRP‐DT, was an independent prognostic parameter for these disease outcomes.

Total Serum Alkaline Phosphatase Activity in Dogs with Mammary Neoplasms: a Prospective Study on 79 Natural Cases

“…In humans, serum levels of certain tumour markers, including ALP, increased along with tumour size (Yudoh et al, 1996), but not in dogs with metastatic liver disease (McConnell and Lumsden, 1983), as it was also the case in our study with mammary neoplasms.…”

“…Marked TALP increases were noticed in dogs with mammary tumours, and other neoplasms (Hamilton et al., 1973; McConnell and Lumsden, 1983; Center, 1996; Leveille‐Webster, 2000), but they have never been associated with the malignancy and histopathological typing. The increased serum TALP in a certain number of canine mammary tumours could be the result of an exaggerated osteoblastic activity of neoplastic cells, leading to increased BALP production, as it has also been seen in some canine and human osteosarcomas and soft tissue sarcomas (Levine and Rosenberg, 1979; Leung et al., 1993; Yudoh et al., 1996; Ehrhart et al., 1998). Moreover, increased tissue‐ALP activities were found in the myoepithelial cells of both normal and neoplastic canine mammary glands (Hamilton et al., 1973; Tateyama and Cotchin, 1977).…”

C-Reactive Protein Is an Important Biomarker for Prognosis Tumor Recurrence and Treatment Response in Adult Solid Tumors: A Systematic Review

“…CRP predicted prognosis in 23 of 24 (96%) studies in pancreatic cancer [ 68 – 71 ], 22 of 24 (92%) in lung cancer [ 25 , 72 – 74 ], all 10 in hepatocellular carcinoma (HCC) [ 75 – 77 ], all 5 in melanoma [ 23 , 78 ], 4 of 7 (57%) in breast cancer [ 79 , 80 ], 12 of 12 (100%) in bladder cancer [ 81 – 83 ], 7 of 9 (78%) in prostate cancer [ 84 – 86 ] and 21 of 24 (88%) others (cervical cancer, ovarian cancer, bone and soft tissue etc.) [ 87 – 91 ]. 14 of 15 (93%) studies of heterogeneous cancers found high CRP to be a predictor of prognosis [ 92 – 94 ] ( Table 2 , Fig 2 ).…”

Inflammation and cancer: how friendly is the relationship for cancer patients?

“…C-reactive protein (CRP), an NF-κB-regulated gene product first linked to cardiovascular diseases, has recently been linked with prognosis of cancers of the breast (97), colon (98), kidney (99), ovary (100)lung (101) and stomach (51), and multiple myeloma (102), melanoma (103), and non-Hodgkin's lymphoma (104). Thus CRP is emerging as an important prognostic marker in a wide variety of cancers.…”