Postoperative C‐reactive protein concentrations to predict infective complications of gastric cancer

110 Background: S-1 plus cisplatin has been recognized as the standard chemotherapy for metastatic gastric cancer (MGC). Inflammation is considered to be a critical component of tumor progression. C-reactive protein (CRP) has been associated with the development of many cancers, but the significance of CRP remains unclear for MGC. The present study assessed the relationship between serum levels CRP and antitumor effects in MGC. Methods: Among 109 MGC patients who received S-1 plus cisplatin as first-line chemotherapy from January 2006 to December 2011 in 3 Japanese institutions, we retrospectively identified 70 patients who fulfilled eligibility criteria of this study. Patients were categorized into 2 groups depending on serum CRP level before chemotherapy: 43 patients with CRP <1.0 mg/dl (CRP <1.0 group) and 27 patients with CRP ≥1.0 mg/dl (CRP ≥1.0 group). Results: Median overall survival was significantly shorter in the CRP ≥1.0 group than in the CRP <1.0 group [267 days (95% CI, 208 to 326) versus 416 days (95% CI, 325 to 507); p = 0.0007]. Moreover, progression-free survival (PFS) was significantly shorter in the CRP ≥1.0 group than in the CRP <1.0 group (median PFS 126 days [95% CI, 63 to 189) versus 188 days (95% CI, 159 to 217); p = 0.0050]. Meanwhile, response rate was determined in 58 patients with target lesions. No significant differences were noted between the CRP <1.0 group and the CRP ≥1.0 group (10/33, 30.3% versus 7/25, 28.0%; p = 0.663). In a multivariate analysis, serum CRP level before chemotherapy was an only independent prognostic factor for MGC (hazard ratio 3.09 (95% CI, 1.46 to 6.54); p = 0.003). Conclusions: Serum CRP level before chemotherapy might be an independent and potential prognostic factor for MGC. Stringent follow-up during chemotherapy is expected for patients with MGC and a high CRP level.

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C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.26 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 26-26

Author(s):

Kazumasa Fujitani ◽

Yuji Shishido ◽

Kazuyoshi Yamamoto ◽

Motohiro Hirao ◽

Toshimasa Tsujinaka ◽

...

Keyword(s):

Gastric Cancer ◽

Early Detection ◽

Diagnostic Accuracy ◽

Predictive Factors ◽

Infectious Complications ◽

C Reactive Protein ◽

Cancer Resection ◽

Reactive Protein ◽

Gastric Cancer Resection ◽

Grade Iii

26 Background: Postoperative infectious complications (PICs) after gastric cancer resection remain a clinically relevant problem. Early detection of PICs, before critical illness develops, may be of considerable clinical benefit. The aims of this study were to investigate the predictive factors for PICs and to define the clinical parameters for their early detection in patients with gastric cancer resection. Methods: Clinical data of 417 consecutive patients undergoing elective gastrectomy for primary gastric cancer between 2009 and 2012 were retrospectively analyzed. Diagnostic accuracy was determined by the area under the receiver operating characteristic curve (AUC). Univariate and multivariate logistic regression analyses identified clinical factors predicting PICs of grade III or more according to the Clavien-Dindo classification. Results: Forty-four patients developed PICs of grade ≥ III (10.6%, 95% confidence interval [CI] 7.6–13.5%). As a systemic inflammatory marker, C-reactive protein (CRP) on postoperative day (POD) 3 had superior diagnostic accuracy for PICs (AUC 0.802, 95% CI 0.735–0.870) with a calculated cut-off value of 17.7 mg/dl, yielding a sensitivity of 0.66 (95% CI 0.524–0.774) and a specificity of 0.84 (95% CI 0.821–0.850). Multivariate analysis identified CRP on POD 3 of 17.7 mg/dl or greater (odds ratio [OR] 8.094, 95% CI 3.568–19.342) as well as clinical stage ≥ II (OR 4.445, 95% CI 1.478–15.881) and operation time ≥ 250 min (OR 3.638, 95% CI 1.449–10.137) as significant predictive factors for PICs after gastrectomy. Conclusions: Elevated CRP levels on POD 3 will help physicians predict postoperative course and facilitate decision-making regarding the prompt, comprehensive clinical search and therapeutic approach for PICs.

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The prognostic value of systemic inflammatory factors in patient with metastatic gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15505 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15505-e15505 ◽

Cited By ~ 2

Author(s):

Georgy M. Manikhas ◽

Natalia P. Beliak ◽

Svetlana I. Kutukova ◽

Natalia V. Zhukova ◽

Natalia V. Popova ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Inflammatory Markers ◽

Prognostic Biomarker ◽

Metastatic Gastric Cancer ◽

Neutrophil To Lymphocyte Ratio ◽

C Reactive Protein ◽

Platelet To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Reactive Protein

e15505 Background: Inflammation seems to be significant factor in carcinogenesis and tumor progression of numerous cancers. Blood calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), lactate dehydrogenase (LDH), international normalized ratio (INR) can be evaluated as systemic inflammation markers and prognostic biomarker for many aims: survival outcomes, lymph node metastasis and recurrence, treatment responses in a variety of cancers. The purpose of this study was to investigate baseline associations between blood test parameters (NLR, PLR, LDH, CRP, INR) and their prognostic biomarker role for patient with metastatic gastric cancer, undergoing first-line chemotherapy Methods: Potential baseline inflammatory markers (platelets, neutrophils, lymphocytes, the platelet-lymphocyte ratio, the neutrophil-lymphocyte ratio, the serum C-reactive protein [CRP], the serum LDH, INR) were retrospectively analyzed in 32 patients with metastatic gastric cancer, IV stage (median of age – 60,50). Multivariate analyses were used to identify prognostic factors for overall survival (OS). Baseline values were compared with tumor characteristic and median survival times (MSTs). Results: Multivariate analysis identified due to Cox proportional-hazards regression showed significant longest OS in patients with: localization of primary tumor in antral part of gastric (HR 0,45, 95% CI 0,25-0,80, p = 0,0065); low baseline’s level of WBC (HR 1,17, 95% CI 1.02 - 1,35, p = 0,0219); low baseline’s level of neutrophil (HR 1,18, 95% CI 1.02 - 1,34, p = 0,0251). Level of LDH, CRP, INR didn’t show significant ratio for this cohort of patient. Peritoneum metastatic also didn’t significant affect on OS in patient with metastatic gastric cancer. Patients with low baseline’s platelet to lymphocyte ratio (HR 1,004, 95% CI 1,0009-1,0072, p = 0,0125) and low (from 0 to 3,0) neutrophil to lymphocyte ratio (HR 1,81, 95% CI 1,09-2,99, p = 0,0212) had a significantly longest OS time. Conclusions: Inflammatory markers can predict overall survival in stage IV gastric cancer. Simple and useful.

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