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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
Author(s) -
Køstner Anne Helene,
Kersten Christian,
Löwenmark Thyra,
Ydsten Karin A.,
Peltonen Reetta,
Isoniemi Helena,
Haglund Caj,
Gunnarsson Ulf,
Isaksson Bengt
Publication year - 2016
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.24415
Subject(s) - medicine , hypoalbuminemia , colorectal cancer , systemic inflammation , c reactive protein , gastroenterology , multivariate analysis , biomarker , oncology , stage (stratigraphy) , proportional hazards model , cancer , inflammation , paleontology , biochemistry , chemistry , biology
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. J. Surg. Oncol. 2016;114:895–899 . © 2016 2016 Wiley Periodicals, Inc.