The prognostic value of the serum level of C-reactive protein for the survival of patients with a primary sarcoma of bone

Nakamura, Tomoki; Grimer, R. J.; Gaston, Czar Louie; Watanuki, Munenori; Sudo, Akihiro; Jeys, Lee

doi:10.1302/0301-620x.95b3.30344

Cited by 49 publications

(62 citation statements)

References 27 publications

(35 reference statements)

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“…However, there are few studies performed to assess the association between CRP levels and prognosis of osteosarcoma patients. Nakamura et al assessed the prognostic value of the serum level of Creactive protein for the survival of patients with a primary sarcoma of bone [23]. A study published in 2011 showed that preoperative serum CRP was an independent prognostic factor for survival in patients with high-grade osteosarcoma, which was consistent with the findings in our study [24].…”

Section: Discussionsupporting

confidence: 90%

Serum C-reactive protein and overall survival of patients with osteosarcoma

Tian

Wang

et al. 2015

Tumor Biol.

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Increased level of serum C-reactive protein (CRP) has been identified as an important prognostic factor in several types of cancers. However, the prognostic significance of serum CRP levels in patients with osteosarcoma was still unclear. A retrospective cohort study of 85 patients was performed to assess the prognostic significance of serum CRP level in osteosarcoma. Both log-rank test and multivariable analysis by Cox regression model were used to assess the impact of serum CRP levels on the overall survival in patients with osteosarcoma. Among those 85 patients, 28 (32.9 %) had high serum CRP level (>1 mg/dL), while the other 57 (67.1 %) patients had normal serum CRP level (≤ 1 mg/dL). There was no obvious difference in the baseline characteristics between high CRP group and normal CRP group. Kaplan-Meier product-limit method showed that patients with high serum CRP levels had significantly poorer overall survival than those patients with normal serum CRP levels (log-rank test P = 0.0008). Multivariable analysis by Cox regression model further showed that high serum CRP level was an independent predictor of poor overall survival (hazard ratio [HR] = 2.39; 95 % confidence interval [95 % CI] 1.22-4.67, P = 0.01). Thus, serum CRP level has an important prognostic significance in patients with osteosarcoma, and high CRP level is associated with worse overall survival.

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Section: Discussionsupporting

confidence: 90%

Serum C-reactive protein and overall survival of patients with osteosarcoma

Tian

Wang

et al. 2015

Tumor Biol.

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“…Of these, 11 were initially excluded after reading the abstracts (Figure 1). As a result, the systematic literature search generated a total of 2 datasets [5], [22] and 397 patients for ultimate analysis. These data were published from 2011 to 2013 to fit the inclusion criteria for our meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The survival data were summarized from 2 eligible studies [5], [22] and analyzed the correlation between CRP and histological response to neoadjuvant chemotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…2 selected studies [5], [22] were evaluated by two reviewers with high levels of methodological quality (>6 stars) according to Newcastle-Ottawa quality assessment scale [28].…”

Section: Resultsmentioning

confidence: 99%

“…About 15–20% patients present with overt lung metastases at initial diagnosis and 40% patients develop metastases at a later stage [3], [4]. Despite multidisciplinary treatments including surgery, neoadjuvant and adjuvant chemotherapy, the overall five-year survival rate for OS remains 60–70% [5]. The mechanism underlying OS metastasis is still limited, neovascularization, invasion, anoikis resistance, chemoresistance, and evasion of the immune response are considered to be required for progression and metastasis in OS [6].…”

Section: Introductionmentioning

confidence: 99%

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C-Reactive Protein as a Prognostic Factor for Human Osteosarcoma: A Meta-Analysis and Literature Review

Wang

et al. 2014

PLoS ONE

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BackgroundOsteosarcoma is the most common primary bone cancer in growing adolescents and young adults. The prognostic role of C-reactive protein (CRP) in patients with osteosarcoma is not fully investigated. The purpose of this study is to perform a meta-analysis and literature review on the role of CRP in osteosarcoma and to assess the potential role of serum CRP as a prognostic factor for patients with osteosarcoma.MethodsA detailed literature search was made in Medline for related research publications written in English. Methodological quality of the studies was also evaluated. The data were extracted and assessed by two reviewers independently. Analysis of pooled data were performed, risk ratio (RR) and corresponding confidence intervals (CIs) were calculated and summarized respectively.ResultsFinal analysis of 397 patients from 2 eligible studies was performed. Combined RR of CRP expression suggested that the raised serum CRP level had an adverse prognostic effect on overall survival of patients with osteosarcoma (n = 397 in 2 studies; RR = 0.35; 95% CI: 0.18–0.68; p = 0.002). In the uni- and multivariate survival analysis, response rate and CRP levels were the only independent prognostic variables.ConclusionsThe results of this meta-analysis suggest that CRP expression confers a worse prognosis in patients with osteosarcoma. Large prospective studies are necessary to provide solid data to confirm the prognostic significance of CRP.

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Prediction of prognosis using artificial intelligence‐based histopathological image analysis in patients with soft tissue sarcomas

Hagi,

Nakamura,

Yuasa

et al. 2024

Cancer Medicine

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BackgroundPrompt histopathological diagnosis with accuracy is required for soft tissue sarcomas (STSs) which are still challenging. In addition, the advances in artificial intelligence (AI) along with the development of pathology slides digitization may empower the demand for the prediction of behavior of STSs. In this article, we explored the application of deep learning for prediction of prognosis from histopathological images in patients with STS.MethodsOur retrospective study included a total of 35 histopathological slides from patients with STS. We trained Inception v3 which is proposed method of convolutional neural network based survivability estimation. F1 score which identify the accuracy and area under the receiver operating characteristic curve (AUC) served as main outcome measures from a 4‐fold validation.ResultsThe cohort included 35 patients with a mean age of 64 years, and the mean follow‐up period was 34 months (2–66 months). Our deep learning method achieved AUC of 0.974 and an accuracy of 91.9% in predicting overall survival. Concerning with the prediction of metastasis‐free survival, the accuracy was 84.2% with the AUC of 0.852.ConclusionAI might be used to help pathologists with accurate prognosis prediction. This study could substantially improve the clinical management of patients with STS.

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The prognostic value of the serum level of C-reactive protein for the survival of patients with a primary sarcoma of bone

Cited by 49 publications

References 27 publications

Serum C-reactive protein and overall survival of patients with osteosarcoma

Serum C-reactive protein and overall survival of patients with osteosarcoma

C-Reactive Protein as a Prognostic Factor for Human Osteosarcoma: A Meta-Analysis and Literature Review

Prediction of prognosis using artificial intelligence‐based histopathological image analysis in patients with soft tissue sarcomas

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