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Increased C-reactive protein implies a poorer stage-specific prognosis in colon cancer
Southern Hospital Trust, Kristiansand, Norway.
University of Helsinki, Finland.
Turku University Hospital, Turku, Finland.
Pkorvoo Hospital, Porvoo, Finland.
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2013 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 52, no 8, 1691-1698 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To characterize the stage-specific prognostic relevance of preoperative systemic inflammatory response, defined by C-reactive protein (CRP), in colon cancer (CC) patients.

MATERIAL AND METHODS: Data from CC patients operated on from 1998 to 2007 at three hospitals from three different Nordic countries were collected retrospectively from national registries, local databases and/or patient records. Patients with emergency surgery, infection or auto-immune disease were excluded. Associations between clinical or histopathological variables and CRP were assessed. Patients were followed from the date of surgery to death or end of follow-up. Disease-specific survival (DSS) was the main endpoint.

RESULTS: In total, 525 patients with age and stage distributions which were representative for CC patients were included. None of the patients was lost to follow-up. Age, TNM Stage, WHO differentiation grade and right-sided tumor location significantly associated with elevated CRP values, in contrast to postoperative morbidity, which did not. CRP levels were found to be a strong prognostic factor for DSS in CC. The risk of death due to CC was augmented with increasing levels of CRP in every stage of operated CC. Both short- and long-term DSS were impaired. The sub-hazard ratios for CRP-levels above 60 mg/L were 7.37 (CI 2.65-20.5) for stage I+ II, compared to 3.29 (CI 1.30-8.29) for stage III and 2.24 (CI 1.16-4.35) for stage IV.

CONCLUSION: Increase of CRP concentrations correlate with clinically relevant poorer disease-specific survival in each stage of CC.

Place, publisher, year, edition, pages
Informa Plc , 2013. Vol. 52, no 8, 1691-1698 p.
National Category
URN: urn:nbn:se:umu:diva-83436DOI: 10.3109/0284186X.2013.835494ISI: 000325526300015PubMedID: 24102179OAI: diva2:667142
Available from: 2013-11-25 Created: 2013-11-25 Last updated: 2016-06-02Bibliographically approved

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