The impact of preoperative serum C‐reactive protein on the prognosis of patients with hepatocellular carcinoma

Hashimoto, Koji; Ikeda, Yasuharu; Korenaga, Daisuke; Tanoue, Kazuo; Hamatake, Motoharu; Kawasaki, Katsumi; Yamaoka, Terutoshi; Iwatani, Yasue; Akazawa, Kohei; Takenaka, Katsuto

doi:10.1002/cncr.20976

Cited by 239 publications

(221 citation statements)

References 35 publications

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“…Recent studies have showed that the preoperative elevated serum CRP level is an independent and significant predicative indicator of poor prognosis and early recurrence in patients with HCC (Hashimoto et al, 2005;Sieghart et al, 2013). However, SAA is superior to CRP for detecting inflammation resulting from viral infections, kidney transplantation, Crohn's disease, and ulcerative colitis (Yamada, 1999), and therefore SAA is probably more useful for detecting slight elevations in systemic or chronic inflammation.…”

Section: Discussionmentioning

confidence: 99%

Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular Carcinoma

Ni¹,

Ye²,

Fu³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Purpose: To investigate the prognostic value of serum amyloid A (SAA) in patients with hepatocellular carcinoma (HCC) undergoing surgery. Materials and Methods: Preoperative serum samples of 328 patients with HCC who underwent curative resection and of 47 patients with benign liver lesion were assayed. Serum levels of SAA were measured by enzyme-linked immunosorbent assay and its correlations with clinicopathological characteristics and survival were explored. Results: Levels of SAA were significantly higher in patients with HCC than those with benign liver lesion. There were strong correlations between preoperative serum SAA level and tumor size and more advanced BCLC stage. On univariate analysis, elevated SAA was associated with reduced disease-free survival and overall survival (p=0.001 and 0.03, respectively). Multivariate analyses showed that serum SAA level was an independent prognostic factor for overall survival (hazard ratio 2.80, p=0.01). Conclusions: High SAA serum level is a novel biomarker for the prognosis of HCC patients.

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Section: Discussionmentioning

confidence: 99%

Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular Carcinoma

Ni¹,

Ye²,

Fu³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Alterations of serum CRP is a common feature in patients with malignancies which has been found to be adversely prognostic, with patients having elevated CRP levels (Nozoe et al, 1998;Nakanishi et al, 2002;Shimada et al, 2003;Hashimoto et al, 2005). Growing evidence suggests prognostic importance because increased CRP levels are associated with the production of cytokines from tumour cells (Kurzrock, 1997;Legouffe et al, 1998, Yamamura et al, 1998.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the prognostic value of baseline biological markers including high levels of b2-microglobulin (B2-M), lactate dehydrogenase (LDH), and serum albumin (Bataille et al, 1992), elevations of serum C-reactive protein (CRP) have been consistently associated with a poor prognosis in myeloma (Tienhaara et al, 1994;Kaneko et al, 2002;Terpos et al, 2003). Several studies regarding the role of preoperative CRP as a predictive indicator for the malignant potential and prognosis in various other cancers have been published (Nozoe et al, 1998;Nakanishi et al, 2002;Shimada et al, 2003;Hashimoto et al, 2005). However, the prognostic significance based on preoperative CRP has not been clarified for myeloma patients, yet.…”

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confidence: 99%

Preoperative elevation of serum C – reactive protein is predictive for prognosis in myeloma bone disease after surgery

et al. 2006

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We investigated whether preoperative levels of serum C-reactive protein (CRP) and its correlation with tumour clinicopathological findings adds prognostic information beyond the time of diagnosis in patients with myeloma bone disease (MM) to facilitate the surgical decision-making process. Six hundred and fifty-eight myeloma patients were evaluated retrospectively for surgery. Clinicopathological variables of patients who underwent surgery (n ¼ 71) were compared between patients with preoperative CRP X6 mg l À1 and those with CRP o6 mg l À1 . Univariate and multivariate analyses were performed to identify prognostic factors after surgery. Patients with an increase of CRP prior to surgery showed inferior survival compared to patients with normal levels. Patients with normal CRP levels at diagnosis but elevations prior to surgery do seem to have a similar unfavourable overall survival (OS) than patients with an increase both, at diagnosis and at surgery. Conversely, patients with normal CRP levels prior to surgery still have the best OS, irrespective of their basic values. Multivariate analysis revealed preoperative CRP levels above 6 mg l À1 Lactate dehydrogenase (LDH) above normal, and osteolyses in long weight bearing bones as independent predictors of survival. These findings suggest that in patients with MM serum levels of CRP increase during disease activity and might be significantly correlated with specific disease characteristics including adverse prognostic features such as osteolyses in long weight bearing bones. Thus, preoperative elevated CRP serum levels might be considered as independent predictor of prognosis and could provide additional prognostic information for the risk stratification before surgical treatment in patients with myeloma bone disease.

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“…In fact, several studies have reported a prognostic value of elevated CRP levels in different types of cancer [8][9][10] including resectable HCC. [11][12][13] In this study we investigated the prognostic value of CRP levels in nonsurgical HCC patients with respect to the BCLC classification.…”

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confidence: 99%

Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

et al. 2013

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We investigated the prognostic value of C-reactive protein (CRP) in patients with hepatocellular carcinoma (HCC) not amenable to surgery. A total of 615 patients diagnosed with HCC not amenable to surgery between April 1999 and December 2009 at the Department of Gastroenterology of the Medical Universities of Vienna and Innsbruck were included. We assessed the optimal CRP cutoff by regression spline analysis and tested its impact on median overall survival (OS) by the Kaplan-Meier method, univariate analysis (log-rank test), and multivariate analysis (Cox proportional hazard regression model) in a training cohort (n 5 466, Vienna) and an independent validation cohort (n 5 149, Innsbruck). We found a sigmoid-shaped association of CRP and the hazard ratio of death upon regression spline analysis and defined a CRP level <1/1 mg/dL as optimal cutoff for further survival assessments. Elevated CRP (1 mg/dL) at diagnosis was associated with poor OS (CRP-elevated versus CRP-normal; 4 versus 20 months; P < 0.001) and remained a significant negative predictor for OS upon multivariate analysis (hazard ratio, 1.7; P < 0.001), which was independent of age, Child-Pugh class, tumor characteristics, and treatment allocation. Analyses with respect to Barcelona Clinic Liver Cancer (BCLC) stage and Child-Pugh class supported the relevance of CRP (BCLC-stage C and Child-Pugh A: OS for CRP-elevated versus CRP-normal, 6 versus 14; P < 0.001; BCLC-stage C and Child-Pugh B: OS for CRP-elevated versus CRP-normal, 4 versus 15 months; P < 0.001). The prognostic significance of elevated CRP was reproducible at a second CRP determination timepoint and confirmed in the independent validation cohort. Conclusion: Elevated CRP is associated with a dismal prognosis in HCC patients and may become a useful marker for patient selection in HCC management.

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The impact of preoperative serum C‐reactive protein on the prognosis of patients with hepatocellular carcinoma

Cited by 239 publications

References 35 publications

Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular Carcinoma

Serum Amyloid A is a Novel Prognostic Biomarker in Hepatocellular Carcinoma

Preoperative elevation of serum C – reactive protein is predictive for prognosis in myeloma bone disease after surgery

Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

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