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. 2014 Jan 7;110(1):183-8.
doi: 10.1038/bjc.2013.701. Epub 2013 Nov 7.

Validation of C-reactive protein levels as a prognostic indicator for survival in a large cohort of pancreatic cancer patients

J Szkandera  1 , M Stotz  1 , G Absenger  1 , T Stojakovic  2 , H Samonigg  1 , P Kornprat  3 , R Schaberl-Moser  1 , W Alzoughbi  4 , C Lackner  4 , A L Ress  1 , F S Seggewies  1 , A Gerger  5 , G Hoefler  4 , M Pichler  1
Affiliations

Validation of C-reactive protein levels as a prognostic indicator for survival in a large cohort of pancreatic cancer patients

J Szkandera et al. Br J Cancer. .

Abstract

Background: Recent evidence indicates that the host inflammatory response has an important role in the tumour progression. Elevated C-reactive protein (CRP) levels have been previously associated with poor prognosis in several cancer types including small-scale studies in pancreatic cancer (PC) patients. The purpose of the present study was to validate the prognostic impact of plasma CRP levels at date of diagnosis on cancer-specific survival (CSS) in a large cohort of PC patients.

Methods: Data from 474 consecutive patients with adenocarcinoma of the pancreas, treated between 2004 and 2012 at a single centre, were evaluated retrospectively. CSS was analysed using the Kaplan-Meier method. To evaluate the prognostic significance of plasma CRP levels, univariate and multivariate Cox analyses were applied.

Results: High plasma CRP levels at diagnosis were significantly associated with well-established prognostic factors, including high tumour stage and tumour grade and the administration of chemotherapy (P<0.05). In univariate analysis, we observed that a high plasma CRP level was a consistent factor for poor CSS in PC patients (hazard ratio (HR)=2.21; 95% confidence interval (CI)=1.68-2.92, P<0.001). In multivariate analysis, tumour stage, grade, administration of chemotherapy, a high neutrophil-lymphocyte ratio and the highest quartile of CRP levels (HR=1.60, 95% CI=1.16-2.21; P=0.005) were identified as independent prognostic factors in PC patients.

Conclusion: In conclusion, we confirmed a significant association of elevated CRP levels with poor clinical outcome in PC patients. Our results indicate that the plasma CRP level might represent a useful marker for patient stratification in PC management.

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Figures

Figure 1
Figure 1
Kaplan–Meier curve stratified by quartiles of C-reactive protein (CRP) levels regarding cancer-specific survival for patients with pancreatic cancer (n=474, P<0.001).
Figure 2
Figure 2
Kaplan–Meier curve stratified by C-reactive protein according to an optimal cutoff value regarding cancer-specific survival for patients with pancreatic cancer (P<0.001).
See this image and copyright information in PMC

References

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