scholarly journals Preoperative C-reactive protein as a prognostic factor in stage IV colorectal cancer

Author(s):  
Hiroka Kondo ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Shintaro Ishikawa ◽  
Takatsugu Fujii ◽  
...  

Background A prognosis for stage IV colorectal cancer is generally poor. As a result, the development of an appropriate treatment strategy for each individual with this disease within a limited time frame is important. Few studies have been made of CRP in stage IV cases of colorectal cancer so it is unclear whether CRP is a useful prognostic marker for this disease. Thus, the purpose of this study was to clarify the relationship between the preoperative CRP level and the prognosis of stage IV colorectal cancer. Patients and methods Between April 2007 and December 2015, 384 patients with stage IV colorectal cancer who underwent primary resection were included. Patients were divided into high (HCG) and low (LCG) CRP groups based on a preoperative CRP cut-off value of ≥1.0 mg/dL. Postoperative short- and long-term results were examined retrospectively. Results The 5-year survival rate was 24.6% for HCG and 36.7% for LCG, indicating the survival rate for HCG was lower. The study was limited to patients who were unable to undergo R0 surgery. Preoperative CEA levels were higher in HCG while the postoperative chemotherapy induction rate was lower. HCG also showed a significantly lower survival rate than LCG. Multivariate analysis showed that CRP levels above 1.0 mg/dL, poorly differentiated histopathology, and the absence of chemotherapy were risk factors affecting overall survival. Conclusion These results suggest that the preoperative CRP level may be a useful biomarker for the prognosis of incurable stage IV colorectal cancer.

2020 ◽  
Author(s):  
Hiroka Kondo ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Shintaro Ishikawa ◽  
Takatsugu Fujii ◽  
...  

Abstract Background: A prognosis for stage IV colorectal cancer is generally poor. As a result, the development of an appropriate treatment strategy for each individual with this disease within a limited time frame is important. In various malignancies, preoperative high C-reactive protein (CRP) levels may be a possible poor prognostic factor. However, few studies have been made of CRP in stage IV cases of colorectal cancer so it is unclear whether CRP is a useful prognostic marker for this disease. Thus, the purpose of this study was to clarify the relationship between the preoperative CRP level and the prognosis of stage IV colorectal cancer.Patients and methods: Between April 2007 and December 2015, 384 patients with stage IV colorectal cancer who underwent primary resection were included. Patients were divided into high (HCG) and low (LCG) CRP groups based on a preoperative CRP cut-off value of ³1.0 mg/dL. Postoperative short- and long-term results were examined retrospectively.Results: Preoperative carcinoembryonic antigen (CEA) levels were higher in HCG; the number of R0 surgical resections of distant metastases was smaller. The 5-year survival rate was 24.6% for HCG and 36.7% for LCG, indicating the survival rate for HCG was lower. A multivariate analysis of factors affecting survival rates identified CRP >1.0, histopathological type, positive venous infiltration, and R0 inoperability as risk factors. The rate of R0 resection was higher in LCG. Concerning R0 resection patients, differences between HCG and LCG with regard to background factors, including preoperative CEA levels, were not found. In terms of long-term survival, a significant difference in overall survival between the two groups was not observed. The study was limited to patients who were unable to undergo R0 surgery. Preoperative CEA levels were higher in HCG while the postoperative chemotherapy induction rate was lower. HCG also showed a significantly lower survival rate than LCG. Multivariate analysis showed that CRP levels above 1.0 mg/dL, poorly differentiated histopathology, and the absence of chemotherapy were risk factors affecting overall survival.Conclusion: These results suggest that the preoperative CRP level may be a useful biomarker for the prognosis of incurable stage IV colorectal cancer.


2017 ◽  
Vol 60 (10) ◽  
pp. 1041-1049 ◽  
Author(s):  
Keiichi Arakawa ◽  
Kazushige Kawai ◽  
Soichiro Ishihara ◽  
Keisuke Hata ◽  
Hiroaki Nozawa ◽  
...  

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14186-e14186
Author(s):  
Shivi Jain ◽  
Kireet Agrawal ◽  
Shinoj Pattali ◽  
Abhijai Singh ◽  
Kamal Agrawal ◽  
...  

e14186 Background: Overall survival in colorectal cancer is influenced by obesity, age, gender and stage at diagnosis. However, in minority based populations, effect of the above factors on overall survival has not been studied in any detail. Hence, we undertook this retrospective study to evaluate effect of above factors on overall survival in young colorectal cancer patients. Methods: 1,195 subjects with colorectal cancer treated at John H. Stroger Hospital of Cook County between 2000 and 2008 were retrospectively analyzed. 179 subjects with age 50 years and younger were identified. 146 of 179 subjects with available Body Mass Index (BMI) in kg/m2 were included in the study. Effect of BMI, age, sex, race, LDH and CEA levels, stage, site of tumor, smoking and family history on overall survival was evaluated using standard statistical multivariate analysis. Results: In our population, 22 of 146(15%) were underweight (BMI<20), 56 of 146(38.4%) were normal weight (BMI 20-24.9), 46 of 146(31.5%) were overweight (BMI 25-29.9) and 22 of 146(15%) were obese (BMI >30). Male: female ratio was 1.4:1. 75 of 146(51.7%) were African American, 23 of 146(15.9%) were Caucasians. 50 of 146(34.2%) were stage IV colorectal cancer at diagnosis. On univariate analysis, BMI<20(p=0.031, HR 2.1, 95% CI 1.15-3.82), CEA >4ng/ml (p=0.005, HR 1.93, 95% CI 1.21-3.08) and stage IV colorectal cancer (p<0.001, HR 6.1, 95% CI 2.42-15.53) were significantly associated with decreased overall survival. LDH<200 U/L was significantly associated with improved overall survival (p 0.029, HR 0.6, 95% CI 0.391-0.950). On multivariate analysis, stage IV colorectal cancer was a single significant independent predictor of overall survival (p=0.001, 95% CI 2.47-27.78). CEA>4ng/ml was marginally significant for decreased overall survival (p=0.06, 95% CI 0.978-3.015). On the contrary, no statistically significant difference was found on overall survival with age, BMI>20, gender, race, tumor location, smoking and family history. Conclusions: Advanced stage and CEA >4ng/ml are independent prognostic variables for decreased overall survival in minority based population of young colorectal cancer.


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