C-Reactive Protein Level Is an Indicator of the Aggressiveness of Advanced Pancreatic Cancer

Mitsunaga, Shuichi; Ikeda, Masafumi; Shimizu, Satoshi; Ohno, Izumi; Takahashi, Hideaki; Okuyama, Hiroomi; Ueno, Hideki; Morizane, Chigusa; Kondo, Shunsuke; Sakamoto, Yasunari; Okusaka, Takuji; Ochiai, Atsushi

doi:10.1097/mpa.0000000000000465

Cited by 38 publications

(40 citation statements)

References 22 publications

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“…Over the last decades, variables used to assess the immune system and in ammation have gained interest as prognostic biomarkers for the prediction of outcomes for pancreatic cancer. (3,(7)(8)(9)(10)(11) Since immunotherapy may play an important role in the future treatment of pancreatic cancer, our study and future research concerning prognostic systemic in ammatory variables could be of signi cant value. (33) In conclusion, this study showed that an elevated CRP/alb ratio was independently and signi cantly associated with decreased overall survival in patients with PDAC after pancreatic resection.…”

Section: Discussionmentioning

confidence: 89%

“…In recent years, emerging evidence has shown the potential value of a variety of systemic in ammationbased prognostic scores in pancreatic cancer. (3,(7)(8)(9)(10)(11) Serum elevation of C-reactive protein (CRP), an acute-phase protein, has been shown to be a prognostic indicator in a variety of neoplasms. (12)(13)(14)(15) Moreover, hypoalbuminemia brought about by malnutrition and related to cachexia has been reported to be correlated with an unfavourable prognosis of gastrointestinal tumours.…”

Section: Introductionmentioning

confidence: 99%

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The ultimate preoperative C-reactive protein to albumin ratio is a prognostic factor for survival after pancreatic cancer resection

Wijk

Klein

Kanters

et al. 2020

Preprint

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Background Emerging evidence indicates that an elevated C-reactive protein-to-albumin ratio (CRP/albCAR) ratio may be associated with a poor prognosis in pancreatic ductal adenocarcinoma (PDAC). Further evidence showing that this ratio has significant prognostic value could contribute to current prediction models and clinical decision-making.Methods Data were analysed of consecutive patients who underwent curative pancreatic resection between 2013 and 2018 and were histologically diagnosed with PDAC. We investigated the relation between the ultimate preoperative CRP/albCAR ratio and overall survival.Results A total of 163 patients were analysed. Median overall survival was 18 months (IQR 9–36). Multivariate analysis demonstrated that a higher CRP/albCAR ratio (HR 1.745, P = 0.004), a higher age (HR 1.062, P < 0.001), male sex (HR 1.977, P = 0.001), poor differentiation grade (HR 2.812, P < 0.001), and positive para-aortic lymph node(s) (HR 4.489, P < 0.001) were associated with a lower overall survival. Furthermore, a CRP/albCAR ratio ≥ 0.2 was associated with decreased overall survival (16 vs. 26 months, P = 0.003). Conclusion We demonstrated that an ultimate preoperative elevated CRP/albCAR ratio is an independent indicator of decreased overall survival after resection for PDAC. The preoperative CRP/albCAR ratio may be of additional value to the current prediction models.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

The ultimate preoperative C-reactive protein to albumin ratio is a prognostic factor for survival after pancreatic cancer resection

Wijk

Klein

Kanters

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Ultimately, 20 studies [8,[15][16][17][18][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] including 6512 patients were enrolled in this meta-analysis after excluding ineligible studies.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…The prognostic value of mGPS has been confirmed in a variety of solid tumors, such as small cell lung cancer, colorectal cancer, gastric cancer, and ovarian cancer [11][12][13][14]. Several studies proved that mGPS was one of the most important determinants of overall survival (OS) in pancreatic cancer patients [15,16], but others showed contradictory results [17,18]. Therefore, the exactly prognostic value of mGPS remained to be confirmed.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Modified Glasgow Prognostic Score in Pancreatic Cancer: A Meta-analysis

Zhang

Ren

Jin

et al. 2020

Preprint

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Background: Several studies were conducted to explore the prognostic value of modified Glasgow Prognostic Score (mGPS) in pancreatic cancer, which reported contradictory results. The purpose of this meta-analysis was to summarize the prognostic value of mGPS in pancreatic cancer by investigating the correlation between mGPS and overall survival (OS). Methods: A systematic literature search was performed in PubMed, EMBASE, ISI Web of Science, Cochrane library databases and OVID to identify eligible studies published from Jan 1, 2011 to June 20, 2020. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were used to detect the prognostic significance of mGPS in patients with pancreatic cancer. Results: A total of 222 non-repetitive studies were identified, and 20 enrolled studies described the association between survival outcomes and mGPS in pancreatic cancer patients. The results showed a significant correlation between high mGPS and poor OS (HR=1.50, 95% CI=1.20–1.89, P<0.0001). Similar results were observed in the subgroup analyses of OS, which were based on the treatment regimen and research region. Conclusions: Our study suggested the close association between the poor prognosis and high level of mGPS, which will be helpful for future clinical applications in pancreatic cancer patients.

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“…20 Several recent studies demonstrated that pancreatic cancer patients with high CRP levels had poor prognoses. 21,22 However, the cutoff values of for CRP level varied by study, and its significance as a predictor of early recurrence after surgical resection is therefore unclear. Additionally, previous large cohort studies revealed several other prognostic clinicopathologic factors such as lymph node metastasis, pathologic T stage, histologic grade, tumor size, and adjuvant chemotherapy.…”

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confidence: 99%

Prediction of Postoperative Early Recurrence and Prognosis in Pancreatic Cancer Patients

Kurahara¹,

Maemura²,

Mataki³

et al. 2017

International Surgery

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Background: Stratification of pancreatic cancer patients based on early recurrence and prognosis is essential for selecting optimal therapeutic strategies. The aim of this study was to investigate whether serum carbohydrate antigen (CA) 19-9 levels can be better used to predict early recurrence and prognosis. Methods: Patients whose CA 19-9 levels obtained in association with total bilirubin .2.0 mg/dL and whose CA 19-9 levels ,5.0 U/mL were excluded to avoid the influence of obstructive jaundice and Lewis phenotype Le aÀbÀ , respectively. A total of 125 pancreatic cancer patients who underwent surgical resection were enrolled. Results: Larger tumor size, higher serum CA 19-9 level, higher C-reactive protein (CRP) level, more advanced T status, and lymph node metastasis were significantly associated with recurrence within 1 year after surgery (early recurrence). The rate of early recurrence in patients with CA 19-9 levels .100 U/mL (76.9%) was significantly higher than that of patients with CA 19-9 levels 100 U/mL (27.9%). We performed combination analysis of 2 additional risk factors, CRP level (cutoff: 1.0 mg/dL) and tumor size (cutoff: 3.0 cm), with serum CA 19-9 level (cutoff: 100 U/mL). Patients were divided into 3 groups according to their number of risk factors. Rates of early recurrence in patients with 0, 1, and 2 or 3 risk factors were 22.0%, 45.2%, and 91.7%, respectively. Moreover, overall survival was significantly different in each group. Conclusion: Serum CA 19-9 level, in addition to CRP level and tumor size, improve patient stratification in early recurrence as well as prognosis.

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C-Reactive Protein Level Is an Indicator of the Aggressiveness of Advanced Pancreatic Cancer

Abstract: C-reactive protein stratified the outcomes, systemic weakness, and tumor burden. C-reactive protein is an indicator of the aggressiveness of advanced PCa.

Cited by 38 publications

References 22 publications

The ultimate preoperative C-reactive protein to albumin ratio is a prognostic factor for survival after pancreatic cancer resection

The ultimate preoperative C-reactive protein to albumin ratio is a prognostic factor for survival after pancreatic cancer resection

The Prognostic Value of Modified Glasgow Prognostic Score in Pancreatic Cancer: A Meta-analysis

Prediction of Postoperative Early Recurrence and Prognosis in Pancreatic Cancer Patients

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