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Meta-Analysis
. 2015 Aug 3:5:12733.
doi: 10.1038/srep12733.

Prognostic Role of C-Reactive Protein In Urological Cancers: A Meta-Analysis

Liang Zhou  1 , Xiang Cai  1 , Qiang Liu  1 , Zhong-Yu Jian  1 , Hong Li  1 , Kun-Jie Wang  1
Affiliations
Meta-Analysis

Prognostic Role of C-Reactive Protein In Urological Cancers: A Meta-Analysis

Liang Zhou et al. Sci Rep. .

Abstract

Growing evidence suggests serum C-reactive protein (CRP) can serve as a prognostic marker in urological cancers. However, some studies yield contradictory results. Our objective was to determine the relationship between baseline serum CRP and survival outcome in urological cancers. We searched PubMed and EMBASE databases until October 2014 without language restrictions. 44 independent studies investigating the association between baseline serum CRP and cancer-specific survival (CSS) or overall survival (OS) were selected. High CRP yielded a worse survival in renal cell carcinoma, prostate cancer, bladder cancer, and upper urinary tract urothelial carcinoma. Combined results of meta-analyses indicated that CRP was a prognostic factor in urological cancers (CSS: p < 0.01; OS: p < 0.01). Subgroup analyses confirmed the significant association between CRP and prognosis, regardless of race and cutoff value of CRP. Specifically, prognostic impact of CRP was also noted in patients with localized RCC treated with nephrectomy (CSS: p < 0.01) and metastatic RCC treated with molecular-targeted therapy (OS: p < 0.01). In conclusion, serum CRP is an independent prognostic factor in urological cancers and risk stratification by serum CRP level could be helpful for prognostic assessment.

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Figures

Figure 1
Figure 1. Flow chart of study selection for the meta-analysis.
Figure 2
Figure 2. Meta-analysis of the association of CRP and clinical outcomes of patients with renal cell carcinoma.
(A): CRP and CSS; (B): CRP and OS.
Figure 3
Figure 3. Meta-analysis of the association of CRP and clinical outcomes of patients with prostate cancer.
(A): CRP and CSS; (B): CRP and OS.
Figure 4
Figure 4. Meta-analysis of the association of CRP and clinical outcomes of patients with urothelial carcinoma or bladder cancer.
(A): CRP and CSS in patients with bladder cancer; (B) CRP and OS in patients with bladder cancer; (C) CRP and CSS in patients with upper urinary tract urothelial carcinoma.
Figure 5
Figure 5
Funnel plot adjusted with trim and fill method for cancer specific survival (A) and overall survival (B). Circles: included studies. Diamonds: presumed missing studies.
See this image and copyright information in PMC

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