Increased C-reactive protein implies a poorer stage-specific prognosis in colon cancer

Kersten, Christian; Louhimo, Johanna; Ålgars, Annika; Lahdesmaki, Aleksi; Cvancerova, Milada; Stenstedt, Kristina; Haglund, Caj; Gunnarsson, Ulf

doi:10.3109/0284186x.2013.835494

Cited by 66 publications

(81 citation statements)

References 23 publications

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“…Like some of the other established markers of SIR, CRP has the advantage of being inexpensive, and it can be measured routinely both in daily clinical practice and in study settings, making it easily accessible, and, in addition, it is also readily and precisely quantifiable [36]. Since increasing CRP values confer an increasingly worse prognosis independent of other well-known prognostic markers, CRP adds important clinical value.…”

Section: Discussionmentioning

confidence: 99%

“…Separate analyses of the prognostic effect of each different inflammatory marker on PFS and OS were performed. Patients were grouped into four CRP categories (≤ 10, 11–30, 31–60, > 60 mg/L), based upon current reference cut-off values in colon cancer [36]. dNLR was dichotomized at the median value 2.1, as no consensus regarding cut-off values exists in the literature, but in accordance with previous publications [37].…”

Section: Methodsmentioning

confidence: 99%

“…Different blood measures for SIR have been proposed [8, 9, 36, 37]. The relationship between these measures and tumorigenic inflammatory processes in CRC is not fully clarified.…”

Section: Introductionmentioning

confidence: 99%

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Interleukin-6 and C-reactive protein as prognostic biomarkers in metastatic colorectal cancer

et al. 2016

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ObjectivesThe aim was to explore the prognostic significance of IL-6 and markers of systemic inflammatory response (SIR), in particular C-reactive protein (CRP), in metastatic colorectal cancer (mCRC) patients, in the total study population and according to RAS and BRAF mutation status.ResultsHigh levels of pretreatment serum IL-6 or CRP were associated with impaired outcome, in terms of reduced PFS and OS. Patients with low versus high serum IL-6 levels had median OS of 26.0 versus 16.6 months, respectively (P < 0.001). Stratified according to increasing CRP levels, median OS varied from 24.3 months to 12.3 months, (P < 0.001). IL-6 and CRP levels affected overall prognosis also in adjusted analyses. The effect of IL-6 was particularly pronounced in patients with BRAF mutation (interaction P = 0.004).Materials and MethodsIL-6 and CRP were determined in pre-treatment serum samples from 393 patients included in the NORDIC-VII trial, in which patients with mCRC received first line treatment. The effect of serum IL-6 and CRP on progression-free survival (PFS) and overall survival (OS) was estimated.ConclusionsHigh baseline serum consentrations of IL-6 or CRP were associated with impaired prognosis in mCRC. IL-6 and CRP give independent prognostic information in addition to RAS and BRAF mutation status.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Interleukin-6 and C-reactive protein as prognostic biomarkers in metastatic colorectal cancer

et al. 2016

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“…[15][16][17] Modulation of immune function measured at baseline and at weeks 6 and 12 will be assessed by changes in general T-cells, regulatory T-cells, cytotoxic T-cells, pro-inflammatory Thelper 17 cells, natural killer cells and dendritic cells by flow cytometry. The functional assessment of cancer therapy questionnaires-fatigue (FACT-F and FACT-G), measured at baseline and at weeks 6 and 12, rated as an average over the last 7 days will measure quality of life in general and specifically fatigue.…”

Section: Secondary Outcomesmentioning

confidence: 99%

AL study- traditional Chinese medicine combination Astragalus membranaceus and Ligustrum lucidum in people with advanced malignancy: research protocol for an open labelled pilot study

et al. 2017

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Background: AL is a traditional Chinese medicine (TCM) combination commonly used as an adaptogen to improve energy levels, immunity and quality of life in those suffering from chronic diseases such as cancer. While the combination Astragalus membranaceus and Ligustrum lucidum (AL) has been investigated in China as an adjunct to standard anticancer therapies in numerous clinical studies of variable quality reported in the Chinese literature, independent assessment of its effects on safety, tolerability and efficacy are lacking. Our objectives are to determine the safety and tolerability of AL and investigate its effects on inflammation, quality of life and immunity in people with advanced malignancy in the Australian healthcare setting. Methods: The AL study is a prospectively registered, open labelled pilot multi-centre study investigating AL in people with advanced malignancy. Inclusion criteria include participants with recurrent or metastatic cancer who are not undergoing chemotherapy or palliative chemotherapy. All participants (n=25) will receive 6 capsules of AL twice daily (equivalent to 25g raw herb) for 12 weeks. Follow up consultations will monitor safety, tolerability, quality of life, immune function and adverse events. Participants will be assessed at baseline and at weeks 3, 6, 9 and 12. The primary outcome will determine the effect of AL on safety and tolerability. Secondary outcomes will include inflammation, quality of life, immune function, disease status and survival. Appropriate statistical analysis will be conducted on the pilot study data. Potential associations will be investigated where relevant. Conclusions: This study will firstly establish the safety and tolerability of this TCM combination "AL" in people with advanced malignancy in the Australian healthcare system and provide important information regarding its effect on markers that may affect survival as well as explore changes in quality of life and immune function. The impact of this research may allow the design of future studies integrating AL with standard therapy for people with advanced malignancy.

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“…Many objective and subjective prognostic factors were examined to evaluate prognostic value to the patients. To date, patient's performance status, diverse physical symptoms, biochemical markers, and other various subjective parameters were known as significant prognostic factors (1)(2)(3)(4)(5)(6)(7)(8)(9). Such prognostic factors provide more accurate clinical information about patients to their physicians.…”

Section: Introductionmentioning

confidence: 99%

Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer

Lee

Seo

et al. 2017

Korean J Hosp Palliat Care

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Purpose:The Palliative Performance Scale (PPS) is a widely used prognostic tool in patients with advanced cancer. This study examines the association between changes in PPS score and survival in patients with advanced cancer. Methods: We identified a cohort of 606 inpatients who died at a Korean university hospital's hospice/palliative care center. For each patient, the PPS score was measured twice according to a standard procedure: 1) upon admission, and 2) three days after admission (D3). "Change on D3" was defined as a difference between initial PPS and PPS on D3. We used a Cox regression modeling approach to explore the association between this score change and survival. Results: The changes in scores were associated with survival. A score change of ＞30% yielded a hazard ratio for death of 2.66 (95% CI 2.19∼3.22), compared to a score change of ≤30%. PPS of ≤30 on D3 also independently predicted survival, with a hazard ratio of 1.67 (95% CI 1.38∼2.02) compared to PPS of ＞30. Conclusion: A change of over 30% in PPS appears to predict survival in hospitalized patients with terminal cancer, even after adjustment for confounders. Changes in PPS may be a more sensitive indicator of impending death than a single PPS measured on the day of admission in terminal cancer patients. Further prospective study is needed to examine this important finding in other populations.

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Increased C-reactive protein implies a poorer stage-specific prognosis in colon cancer

Cited by 66 publications

References 23 publications

Interleukin-6 and C-reactive protein as prognostic biomarkers in metastatic colorectal cancer

Interleukin-6 and C-reactive protein as prognostic biomarkers in metastatic colorectal cancer

AL study- traditional Chinese medicine combination Astragalus membranaceus and Ligustrum lucidum in people with advanced malignancy: research protocol for an open labelled pilot study

Change in Palliative Performance Scale (PPS) Predicts Survival in Patients with Terminal Cancer

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