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Preoperative C‐reactive protein as a prognostic and therapeutic marker for colorectal cancer
Author(s) -
Koike Yuhki,
Miki Chikao,
Okugawa Yoshinaga,
Yokoe Takeshi,
Toiyama Yuji,
Tanaka Koji,
Inoue Yasuhiro,
Kusunoki Masato
Publication year - 2008
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21154
Subject(s) - medicine , carcinoembryonic antigen , colorectal cancer , c reactive protein , stage (stratigraphy) , oncology , chemotherapy , adjuvant chemotherapy , multivariate analysis , adjuvant , gastroenterology , adjuvant therapy , cancer , inflammation , paleontology , breast cancer , biology
Background and Objectives This study aimed to evaluate the significance of preoperative C‐reactive protein (CRP) as a prognostic marker for carcinoembryonic antigen (CEA)‐independent stage I or II colorectal cancer (CRC) patients. Methods Preoperative CRP was measured in 300 CRC patients to assess its relationships with clinicopathological factors and long‐term survival. Based on the results of the initial study, the relationship between preoperative CRP and long‐term survival was evaluated with reference to adjuvant 5‐fluorouracil (5‐FU)‐based chemotherapy in a further 128 stage II patients. Results CRP was associated with disease progression and factors reflecting nutritional depletion such as serum albumin, lymphocyte count and body weight loss ratio. In stage I or II patients, CRP could predict early disease recurrence, even when a CEA test could not. Multivariate analyses revealed that CRP was an independent prognostic variable in stage I or II patients. In the additional 128 stage II patients, CRP‐positive patients showed a 3‐year survival rate of only 55% without adjuvant chemotherapy, but this increased to 90% with adjuvant chemotherapy. Conclusions CRP may be a potent prognostic and therapeutic indicator that provides valuable information for determining the need for adjuvant chemotherapy in stage II CRC patients. J. Surg. Oncol. 2008;98:540–544. © 2008 Wiley‐Liss, Inc.