Background: Colorectal cancer is the second most common cause of cancer death in Western Countries. Overall survival is poor and only half patients, of those treated with curative intent, survive 5 years. Cancer progression depends on a complex interaction of both tumour’s characteristics and host inflammatory response. Circulating levels of C-reactive protein (CRP) has been found to be related to survival in cancer patients. The aim of this study was to analyze whether relationship exists between age, gender, stage of the disease, and CRP serum levels in patients with colorectal cancer. Patients and Methods: Forty-five patients (25 men, 20 women, median age 69 years, range 49-88 years) who underwent curative surgery for colorectal cancer were enrolled in the study. The TNM stage was the following: Stage I: 2 (4.5%), Stage II: 24 (53.3%), Stage III: 19 (42.2%) patients. Overall, preoperative PRC level was 9.737.13 mg/L (median 11, range 1-27 mg/L). Results: The overall survival was 38.113.0 months (median 41 months, 95% CI: 34.4- 47.6months).Asignificant (c2¼13.4, Log rank p<0.001) difference between Stage II and III patients (43.61.7 vs. 38.11.9 months), and between patients with PRC>10 mg/L and those with PRC<11 mg/L (33.02.9 vs. 44.11.7 mg/L; c2¼4.8, Log rank p<0.03) was found, while there was no difference according to gender (c2¼0.41, Log rank p<0.52). Using the multivariate Cox model analysis (forward stepwise method), adjusted for age, both PRC and stage of the disease were independently related to survival. The relative risk (RR) was 3.5 (95%CI: 1.5-8.2), and 8.1 (95% CI: 3.0-21.3), respectively. Conclusions: Our results suggest that systemic inflammatory response, as shown by raised circulating levels of CRP, is an independent prognostic factor in patients with colorectal cancer, allowing to a better clinical stratification of patients.
Role of C-reactive protein in predicting survival of patients withcolorectal cancer
LUMACHI, FRANCO;ERMANI, MARIO;
2010
Abstract
Background: Colorectal cancer is the second most common cause of cancer death in Western Countries. Overall survival is poor and only half patients, of those treated with curative intent, survive 5 years. Cancer progression depends on a complex interaction of both tumour’s characteristics and host inflammatory response. Circulating levels of C-reactive protein (CRP) has been found to be related to survival in cancer patients. The aim of this study was to analyze whether relationship exists between age, gender, stage of the disease, and CRP serum levels in patients with colorectal cancer. Patients and Methods: Forty-five patients (25 men, 20 women, median age 69 years, range 49-88 years) who underwent curative surgery for colorectal cancer were enrolled in the study. The TNM stage was the following: Stage I: 2 (4.5%), Stage II: 24 (53.3%), Stage III: 19 (42.2%) patients. Overall, preoperative PRC level was 9.737.13 mg/L (median 11, range 1-27 mg/L). Results: The overall survival was 38.113.0 months (median 41 months, 95% CI: 34.4- 47.6months).Asignificant (c2¼13.4, Log rank p<0.001) difference between Stage II and III patients (43.61.7 vs. 38.11.9 months), and between patients with PRC>10 mg/L and those with PRC<11 mg/L (33.02.9 vs. 44.11.7 mg/L; c2¼4.8, Log rank p<0.03) was found, while there was no difference according to gender (c2¼0.41, Log rank p<0.52). Using the multivariate Cox model analysis (forward stepwise method), adjusted for age, both PRC and stage of the disease were independently related to survival. The relative risk (RR) was 3.5 (95%CI: 1.5-8.2), and 8.1 (95% CI: 3.0-21.3), respectively. Conclusions: Our results suggest that systemic inflammatory response, as shown by raised circulating levels of CRP, is an independent prognostic factor in patients with colorectal cancer, allowing to a better clinical stratification of patients.Pubblicazioni consigliate
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