Significance of preoperative elevation of serum C-reactive protein as an indicator for prognosis in colorectal cancer

Nozoe, Tetsuo; Murakami, Takashi; Kitamura, Masayuki; Sugimachi, Keizō

doi:10.1016/s0002-9610(98)00204-9

Cited by 205 publications

(167 citation statements)

References 19 publications

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“…It On univariate and multivariate analysis, deprivation, Dukes stage and the systemic inflammatory response were significant independent predictors of overall survival. These results are therefore consistent with previous studies showing an association between deprivation and overall survival (Kogevinas and Porta, 1997;Hole and McArdle, 2002), and the presence of a systemic inflammatory response and overall survival (Nozoe et al, 1998;Nielsen et al, 2000) in patients undergoing apparently curative surgery for colorectal cancer.…”

Section: Discussionsupporting

confidence: 93%

The effect of deprivation and the systemic inflammatory response on outcome following curative resection for colorectal cancer

2003

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Section: Discussionsupporting

confidence: 93%

The effect of deprivation and the systemic inflammatory response on outcome following curative resection for colorectal cancer

2003

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“…Alterations of serum CRP is a common feature in patients with malignancies which has been found to be adversely prognostic, with patients having elevated CRP levels (Nozoe et al, 1998;Nakanishi et al, 2002;Shimada et al, 2003;Hashimoto et al, 2005). Growing evidence suggests prognostic importance because increased CRP levels are associated with the production of cytokines from tumour cells (Kurzrock, 1997;Legouffe et al, 1998, Yamamura et al, 1998.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the prognostic value of baseline biological markers including high levels of b2-microglobulin (B2-M), lactate dehydrogenase (LDH), and serum albumin (Bataille et al, 1992), elevations of serum C-reactive protein (CRP) have been consistently associated with a poor prognosis in myeloma (Tienhaara et al, 1994;Kaneko et al, 2002;Terpos et al, 2003). Several studies regarding the role of preoperative CRP as a predictive indicator for the malignant potential and prognosis in various other cancers have been published (Nozoe et al, 1998;Nakanishi et al, 2002;Shimada et al, 2003;Hashimoto et al, 2005). However, the prognostic significance based on preoperative CRP has not been clarified for myeloma patients, yet.…”

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confidence: 99%

Preoperative elevation of serum C – reactive protein is predictive for prognosis in myeloma bone disease after surgery

et al. 2006

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We investigated whether preoperative levels of serum C-reactive protein (CRP) and its correlation with tumour clinicopathological findings adds prognostic information beyond the time of diagnosis in patients with myeloma bone disease (MM) to facilitate the surgical decision-making process. Six hundred and fifty-eight myeloma patients were evaluated retrospectively for surgery. Clinicopathological variables of patients who underwent surgery (n ¼ 71) were compared between patients with preoperative CRP X6 mg l À1 and those with CRP o6 mg l À1 . Univariate and multivariate analyses were performed to identify prognostic factors after surgery. Patients with an increase of CRP prior to surgery showed inferior survival compared to patients with normal levels. Patients with normal CRP levels at diagnosis but elevations prior to surgery do seem to have a similar unfavourable overall survival (OS) than patients with an increase both, at diagnosis and at surgery. Conversely, patients with normal CRP levels prior to surgery still have the best OS, irrespective of their basic values. Multivariate analysis revealed preoperative CRP levels above 6 mg l À1 Lactate dehydrogenase (LDH) above normal, and osteolyses in long weight bearing bones as independent predictors of survival. These findings suggest that in patients with MM serum levels of CRP increase during disease activity and might be significantly correlated with specific disease characteristics including adverse prognostic features such as osteolyses in long weight bearing bones. Thus, preoperative elevated CRP serum levels might be considered as independent predictor of prognosis and could provide additional prognostic information for the risk stratification before surgical treatment in patients with myeloma bone disease.

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“…Besides melanoma (Tartour et al, 1994;Tartour et al, 1996), high CRP serum levels are known to indicate shorter median survival in patients suffering from other tumours such as renal cell carcinoma (Blay et al, 1992) or colorectal carcinoma (Gough et al, 1996;Nozoe et al, 1998;Mahmoud and Rivera, 2002). Thus, CRP is not exclusively increased in melanoma.…”

Section: Discussionmentioning

confidence: 99%

Diagnosing melanoma patients entering American Joint Committee on Cancer stage IV, C-reactive protein in serum is superior to lactate dehydrogenase

et al. 2004

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Lactate dehydrogenase (LDH) in serum has recently been introduced into the American Joint Committee on Cancer (AJCC) staging system for cutaneous melanoma because of its prognostic value. We hypothesised LDH to be of value in discriminating melanoma patients entering AJCC stage IV from patients staying in AJCC stages I, II or III. Lactate dehydrogenase was compared to the acute phase protein C-reactive protein (CRP), which we observed to reflect the course of melanoma metastasis in a previous report. In this prospective study, we measured LDH and CRP in the serum of 91 consecutive melanoma patients progressing into AJCC stage IV in comparison to 125 patients staying in AJCC stages I, II or III. Comparing distributions of the parameters by median values and quartiles by Mann -Whitney test, LDH was not significantly elevated in patients entering AJCC stage IV melanoma (P ¼ 0.785), whereas CRP was (Po0.001). Analysing the sensitivity and the specificity jointly by the areas under the receiver operating characteristics curves (ROC-AUC), LDH did not discriminate between the defined groups of patients (AUC ¼ 0.491; 95% confidence interval, 0.410, 0.581), whereas CRP did (AUC ¼ 0.933; 95% confidence interval, 0.900, 0.966; Po0.001). Upon logistic regression analysis to calculate the ROC-AUC values upon the predictive probabilities, LDH provided no additional information to CRP. Choosing a cutoff point of 3.0 mg l À1 , CRP yielded a sensitivity of 0.769 together with a specificity of 0.904 in diagnosing AJCC stage IV entry. Altogether, for first diagnosing AJCC stage IV melanoma, CRP is the superior serum marker when compared to the conventional LDH.

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Significance of preoperative elevation of serum C-reactive protein as an indicator for prognosis in colorectal cancer

Cited by 205 publications

References 19 publications

The effect of deprivation and the systemic inflammatory response on outcome following curative resection for colorectal cancer

The effect of deprivation and the systemic inflammatory response on outcome following curative resection for colorectal cancer

Preoperative elevation of serum C – reactive protein is predictive for prognosis in myeloma bone disease after surgery

Diagnosing melanoma patients entering American Joint Committee on Cancer stage IV, C-reactive protein in serum is superior to lactate dehydrogenase

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