The influence of elevated levels of C‐reactive protein and hypoalbuminemia on survival in patients with advanced inoperable esophageal cancer undergoing palliative treatment

Lindenmann, Joerg; Fink-Neuboeck, Nicole; Koesslbacher, Mario; Pichler, Martin; Stojaković, Tatjana; Roller, Regina E.; Maier, Andrea B.; Anegg, Udo; Smolle, Josef; Smolle‐Jüttner, Freyja‐Maria

doi:10.1002/jso.23711

Cited by 55 publications

(49 citation statements)

References 26 publications

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“…The connection of hypoalbuminemia, inflammation, and deprived survival in colorectal cancer patients could previously be shown by Al-Shaiba et al [49]. In addition, increasing evidence indicates that hypoalbuminemia is strongly connected with poor survival in gastric and esophageal cancer [26, 48, 50]. Especially against that background, it is quite surprising that we did not find significant correlation between hypoalbuminemia and OS ( p = 0.76) and DFS ( p = 0.88) in our patients' collective.…”

Section: Discussionmentioning

confidence: 94%

Comparison of Inflammation-Based Prognostic Scores in a Cohort of Patients with Resectable Esophageal Cancer

Jomrich

Paireder

Gleiß

et al. 2017

Gastroenterology Research and Practice

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Background A number of studies have revealed that inflammation-based prognostic scores, such as Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), and C-reactive protein and albumin ratio (C/A ratio), are associated with poor outcome in cancer patients. However, until now, no study has investigated the role of these prognostic scores in a cohort of neoadjuvant-treated esophageal adenocarcinomas (nEAC) and squamous cell carcinomas (nESCC). Methods Patients had laboratory measurements within three days before resection. GPS, mGPS, and C/A ratio were tested together with established clinicopathological factors in simple and multiple Cox regression analysis of overall survival (OS) and disease-free survival (DFS). Results A total of 283 patients (201 EAC and 82 ESCC) with locally advanced esophageal cancer were enrolled. 167 patients received neoadjuvant treatment (59.0%). Simple analysis revealed that there were significant differences in cancer-specific survival in relation to elevated C-reactive protein (p = 0.011), lymph node status (p < 0.001), UICC stage (p < 0.001), and nEAC (p = 0.005). mGPS (p = 0.024) showed statistical significance in simple analysis. No statistical significance could be found for GPS (p = 0.29), mGPS (p = 0.16), and C/A ratio (p = 0.76) in multiple analysis. Conclusion The investigated prognostic scores should be used and interpreted carefully, and established factors like histology, including tumor size and differentiation, lymph node involvement, and status of resection margin remain the only reliable prognostic factors for patients suffering from resectable EC.

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Section: Discussionmentioning

confidence: 94%

Comparison of Inflammation-Based Prognostic Scores in a Cohort of Patients with Resectable Esophageal Cancer

Jomrich

Paireder

Gleiß

et al. 2017

Gastroenterology Research and Practice

View full text Add to dashboard Cite

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“…Therefore, it seems to be reasonable that CRP levels reflect the activity of tumors. On the other hand, serum Alb is used as an indication of nutritional status, and it has been reported that low serum Alb levels are associated with survival outcomes in various types of cancers . Elevation of CRP/Alb ratio reflects both elevated serum CRP concentrations and hypoalbuminemia and may be more useful for evaluating the condition of a disease and predicting long‐term outcomes of malignancy.…”

Section: Discussionmentioning

confidence: 99%

C‐reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer

Kudou

Saeki

Nakashima

et al. 2018

J of Gastro and Hepatol

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“…Cancer-associated inflammation was a key determinant of cancer initiation, progression, metastasis, and survival [15]. The systemic inflammation-based prognostic factors mainly include GPS, mGPS, CRP/Alb ratio, PLR, and NLR, which were associated with prognosis in various types of cancers [7,14,16,17,18,19,20,21,22]. Previous reports demonstrated that the systemic inflammatory response plays an important role in carcinogenesis and tumor progression [15,23].…”

Section: Discussionmentioning

confidence: 99%

A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma

Chen

Liu

et al. 2016

IJMS

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Recent studies have indicated that inflammation-based prognostic scores, such as the Glasgow Prognostic Score (GPS), modified GPS (mGPS) and C-reactive protein/Albumin (CRP/Alb) ratio, platelet–lymphocyte ratio (PLR), and neutrophil–lymphocyte ratio (NLR), have been reported to have prognostic value in patients with many types of cancer, including nasopharyngeal carcinoma (NPC). In this study, we proposed a novel inflammation-based stage, named I stage, for patients with NPC. A retrospective study of 409 newly-diagnosed cases of NPC was conducted. The prognostic factors (GPS, mGPS, CRP/Alb ratios, PLR, and NLR) were evaluated using univariate and multivariate analyses. Then, according to the results of the multivariate analyses, we proposed a I stage combination of independent risk factors (CRP/Alb ratio and PLR). The I stage was calculated as follows: patients with high levels of CRP/Alb ratio (>0.03) and PLR (>146.2) were defined as I2; patients with one or no abnormal values were defined as I1 or I0, respectively. The relationships between the I stage and clinicopathological variables and overall survival (OS) were evaluated. In addition, the discriminatory ability of the I stage with other inflammation-based prognostic scores was assessed using the AUCs (areas under the curves) analyzed by receiver operating characteristics (ROC) curves. The p value of <0.05 was considered to be significant. A total of 409 patients with NPC were enrolled in this study. Multivariate analyses revealed that only the CRP/Alb ratio (Hazard ratio (HR) = 2.093; 95% Confidence interval (CI): 1.222–3.587; p = 0.007) and PLR (HR: 2.003; 95% CI: 1.177–3.410; p = 0.010) were independent prognostic factors in patients with NPC. The five-year overall survival rates for patients with I0, I1, and I2 were 92.1% ± 2.9%, 83.3% ± 2.6%, and 63.1% ± 4.6%, respectively (p < 0.001). The I stage had a higher area under the curve value (0.670) compared with other systemic inflammation-based prognostic scores (p < 0.001). The I stage is a novel and useful predictive factor for OS in patients with NPC.

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The influence of elevated levels of C‐reactive protein and hypoalbuminemia on survival in patients with advanced inoperable esophageal cancer undergoing palliative treatment

Cited by 55 publications

References 26 publications

Comparison of Inflammation-Based Prognostic Scores in a Cohort of Patients with Resectable Esophageal Cancer

Comparison of Inflammation-Based Prognostic Scores in a Cohort of Patients with Resectable Esophageal Cancer

C‐reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer

A Novel Inflammation-Based Stage (I Stage) Predicts Overall Survival of Patients with Nasopharyngeal Carcinoma

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