Roles of preoperative C-reactive protein are more relevant in buccal cancer than other subsites

Abstract

BackgroundC-reactive protein (CRP) is an early marker for inflammation, and a relationship between serum CRP levels and survival in oral cancer has been demonstrated previously. In this study, we investigated the roles of CRP in different oral cancer subsites.MethodsThree hundred and forty-three oral squamous cell carcinoma patients between June 1999 and March 2015 were retrospectively reviewed. Serum CRP levels were measured preoperatively.ResultsThe elevation of CRP levels (≥5.0 mg/L) was significantly correlated with pathologic tumor status, pathologic nodal status, nodal extracapsular spread, tumor stage, skin invasion, tumor depth (≥10 mm), and bone invasion. The correlation between elevation of CRP and clinicopathologic factors was more evident in the buccal cancer compared to other tumor subsites. The disease-free survival and overall survival correlation was significant in buccal cancer (p = 0.003 and p < 0.001) but not in tongue cancer (p = 0.119 and p = 0.341) or other oral cancer subsites (p = 0.246 and p = 0.696).ConclusionsPreoperative serum CRP level was a prognosticator in oral squamous cell carcinoma, and its effect was more prominent in buccal cancer that occurs more frequently in areca-quid (AQ) endemic regions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-017-1116-5) contains supplementary material, which is available to authorized users.

The Pre-Treatment C-Reactive Protein Represents a Prognostic Factor in Patients with Oral and Oropharyngeal Cancer Treated with Radiotherapy

“…C-reactive protein (CRP), an acute-phase protein, is primarily synthesized by hepatocytes in response to systemic inflammation and has been demonstrated to represent a prognostic factor in various cancer entities including HNSCC [10][11][12][13][14][15][16][17][18][19][20].…”

C‐reactive protein is an independent prognostic marker in patients with tongue carcinoma ‐ A retrospective study

“…A group from Taiwan published several studies about CRP and OSCC and could consistently show an association between elevated CRP (cut‐off 5 mg/L) and survival . In a more recent work, they provided separate results for buccal and tongue cancer, showing significant results for buccal but not for tongue cancer . Another study by Fang et al also described CRP as prognostic marker for overall survival in patients with OSCC and in addition, they used the NLR to further stratify the group with elevated CRP.…”

“…9,[24][25][26] In a German cohort of 261 patients with head and neck cancer, [24][25][26] In a more recent work, they provided separate results for buccal and tongue cancer, showing significant results for buccal but not for tongue cancer. 29 Another study by Fang et al 39 Various explanations for pathologic inflammatory parameters in cancer patients are described in the literature. Since 1863, Virchow postulated that chronic inflammation could play a role in carcinogenesis, and the evidence for this correlation has been increasing.…”

“…To the best of our knowledge, there are only nine studies dealing with oral cancer and CRP, whereas only one was solely investigating patients with tongue carcinoma . So, the aim of this work was to investigate the role of CRP and NLR as prognostic factor for survival in patients with tongue carcinoma.…”

“…16 Studies have shown already a poorer prognosis for patients with high NLR in lung, gastric, ovarian, oesophageal, breast and bladder carcinoma. [17][18][19][20][21][22] To the best of our knowledge, there are only nine studies dealing with oral cancer and CRP, 7,9,[23][24][25][26][27][28][29] whereas only one was solely investigating patients with tongue carcinoma. 30 So, the aim of this work was to investigate the role of CRP and NLR as prognostic factor for survival in patients with tongue carcinoma.…”