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Purpose: C-reactive protein (CRP) has been identified to be associated with cancer development and progression. However, the role of CRP in tumor recurrence is less well defined in biliary tract cancer. Therefore, the aim of this study was to determine the clinical importance of CRP in terms of recurrence of biliary tract cancer after surgical resection. Methods: Sevent-six patients who underwent curative resection for biliary tract cancer from April 2006 to July 2014 were reviewed. Demographics and tumor characteristics were evaluated retrospectively by review of a clinical database and review of pathologic reports. Results: The study group was comprised of 48 men and 28 women, with a mean age of 62.2±10.8 years. Clinical diagnoses of these patients included intrahepatic cholangiocarcinoma (n=6), hilar cholangiocarcinoma (n=13), extrahepatic cholangiocarcinoma (n=21), gall bladder cancer (n=11), and ampullary cancer (n=25). Median follow-up was 35 months. Recurrence-free survival at 1-, 2-, and 5-year was 89%, 76%, and 53%, respectively. On univariate analysis, high CRP level (>3.0 mg/dL) was a significant risk factors for recurrence. Multivariate analysis showed high CRP, poor tumor differentiation, vascular invasion were independent risk factor for tumor recurrence. Conclusion: Preoperative CRP level is significantly associated with recurrence in patients with biliary tract cancer, suggesting the possibility of using CRP as an independent prognostic indicator for biliary cancer.

Preoperative C-reactive protein as a prognostic factor for recurrence after surgical resection of biliary tract cancer