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The prognostic role of systemic inflammation in patients undergoing resection of colorectal liver metastases: C-reactive protein (CRP) is a strong negative prognostic biomarker
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
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2016 (English)In: Journal of Surgical Oncology, ISSN 0022-4790, E-ISSN 1096-9098, Vol. 114, no 7, 895-899 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVES: Systemic inflammation has been associated with poor survival in several tumor types, but has been less extensively studied in resectable metastatic disease. The aim of the present study was to evaluate the prognostic role of CRP in colorectal cancer patients with liver metastases (CRLM) compared to conventional tumor- and patient-related clinicopathological features as well as other indicators of the systemic inflammatory response (SIR).

METHODS: A multinational retrospective study of 492 CRLM patients undergoing potentially curative resection of liver metastases between 1999 and 2009. Clinicopathological findings and the SIR markers CRP, hypoalbuminemia, and their combined Glasgow Prognostic Score (GPS) were analyzed.

RESULTS: Multivariate analysis showed that preoperative CRP >10 mg/L was a strong predictor of compromised survival (HR = 1.72, 95%CI 1.84-2.50, P < 0.01). Patients with CRP ≤10 mg/L had a median survival of 4.27 years compared to only 47 days in patients with CRP ≥30 mg/L (P < 0.01). Similarly, increased GPS was independently predictive of poor survival (HR 1.67, 95%CI 1.22-2.27, P < 0.01), but hypoalbuminemia alone did not have significant prognostic value.

CONCLUSIONS: CRP alone is a strong prognostic factor, following curative resection of colorectal liver metastases and should be taken into consideration when selecting treatment strategies in CRLM patients. 

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016. Vol. 114, no 7, 895-899 p.
Keyword [en]
colorectal cancer, liver metastases, systemic inflammatory response, C-reactive protein, Glasgow prognostic score
National Category
Surgery Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-128560DOI: 10.1002/jso.24415ISI: 000387028900020PubMedID: 27696432OAI: oai:DiVA.org:umu-128560DiVA: diva2:1052577
Available from: 2016-12-07 Created: 2016-12-07 Last updated: 2017-03-17Bibliographically approved

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CiteExportLink to record
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Citation style
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