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

Abstract

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.

C‐reactive protein: An independent predictor for dedifferentiated chondrosarcoma

“…Over the last years, the involvement of systemic inflammation in cancer progression and metastasis has been postulated. 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…”

“…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 Our observation of an association between elevated CRP and worse overall survival is consistent with the previous findings in other malignancies.…”

“…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…”

“…5,6 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] To the best of our knowledge, no previous reports included the C-reactive protein (CRP) as prognostic factor in survival of dedifferentiated chondrosarcoma. For this purpose, we set up a cohort study to analyze the association of pre-operative serum CRP with overall survival in patients with dedifferentiated chondrosarcoma.…”

The Prognostic Role of Glasgow Prognostic Score and C-reactive Protein to Albumin Ratio for Sarcoma: A System Review and Meta-Analysis

“…The inflammation marker CRP (C-reactive protein) and nutrition marker ALB (albumin) are widely used and cheap clinical parameters. Both of them have been found to be predictive of survival in cancer patients [11][12][13][14]. The Glasgow prognostic score (GPS), which was developed based on the combination of CRP and ALB, is considered to reflect both inflammation and nutrition status [15][16][17].…”