C-reactive Protein Is a Predictor of Prognosis of Prostate Cancer: A Systematic Review and Meta-Analysis

Abstract

Increasing evidence suggested that inflammation is associated with the pathogenesis and progression of several solid tumors. This study was conducted to explore the association between C-reactive protein (CRP) and survival of prostate cancer (PCa). An electronic search was completed on the basis of PubMed, Embase and Cochrane Central Register of Controlled Trials. The hazard ratio (HR) and 95% confidence interval (CI) were extracted. Studies evaluating the relation between pretreatment levels of CRP and survival of PCa were included. Sixteen articles incorporating 17,833 patients were eligible for the present meta-analysis. Elevated pretreatment CRP level was significantly associated with poorer overall survival (OS) (HR=1.58, 95% CI 1.31-1.91, P<0.001), cancer-specific survival (CSS) (HR=1.83, 95% CI 1.19-2.80, P=0.006), progression-free survival (PFS) (HR=1.64, 95%CI 1.03-2.61, P=0.036), and biochemical-recurrence free survival (BC-RFS) (HR=1.29, 95% CI 1.11-1.51, P=0.001). Elevated pretreatment serum CRP level is strongly correlated with worse prognosis in patients with PCa, including OS, CSS, PFS and BC-RFS.

Keywords: C-reactive protein; Meta-analysis; Prognosis; Prostate cancer.