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Multicenter Study
. 2021 Jun;30(6):1089-1099.
doi: 10.1158/1055-9965.EPI-20-1752. Epub 2021 Mar 26.

Levels of Inflammation Markers Are Associated with the Risk of Recurrence and All-Cause Mortality in Patients with Colorectal Cancer

Evertine Wesselink  1 , Michiel G J Balvers  2 , Dieuwertje E Kok  2 , Renate M Winkels  2 , Moniek van Zutphen  2 , Ruud W M Schrauwen  3 , Eric T P Keulen  4 , Ewout A Kouwenhoven  5 , Stephanie O Breukink  6   7 , Renger F Witkamp  2 , Johannes H W de Wilt  8 , Martijn J L Bours  6 , Matty P Weijenberg  6 , Ellen Kampman  2 , Fränzel J B van Duijnhoven  2
Affiliations
Multicenter Study

Levels of Inflammation Markers Are Associated with the Risk of Recurrence and All-Cause Mortality in Patients with Colorectal Cancer

Evertine Wesselink et al. Cancer Epidemiol Biomarkers Prev. 2021 Jun.

Abstract

Background: We investigated whether preoperative and postoperative levels of inflammation markers, which have mechanistically been linked to colorectal cancer progression, were associated with recurrence and all-cause mortality in patients with colorectal cancer.

Methods: Data of two prospective cohort studies were used. For the current analysis, patients with stage I to III colorectal cancer were considered. Data on inflammation [IL6, IL8, IL10, TNFα, high-sensitivity C-reactive protein (hsCRP), and a combined inflammatory z-score] were available for 747 patients before surgery and for 614 patients after surgery. The associations between inflammation marker levels and colorectal cancer recurrence and all-cause mortality were examined using multivariable Cox proportional hazard regression models, considering patient characteristics and clinical and lifestyle factors.

Results: Higher preoperative and postoperative hsCRP levels were associated with a higher risk of recurrence [HRper doubling (95% CI), 1.15 (1.02-1.30) and 1.34 (1.16-1.55)] and all-cause mortality [HRper doubling (95% CI) 1.13 (1.01-1.28) and 1.15 (0.98-1.35)]. A doubling in IL8 levels (preoperative levels HR = 1.23; 95% CI, 1.00-1.53 and postoperative levels HR = 1.61; 95% CI, 1.23-2.12) and a higher combined inflammatory z-score (preoperative HRper doubling = 1.39; 95% CI, 1.03-1.89 and postoperative HRper doubling = 1.56; 95% CI, 1.06-2.28) were associated with a higher risk of all-cause mortality, but not recurrence. No associations between IL6, IL10, and TNFα and recurrence or all-cause mortality were observed.

Conclusions: Preoperative and postoperative levels of specific inflammation markers were associated with recurrence and/or all-cause mortality.

Impact: The complex role of inflammation in cancer recurrence merits further elucidation by investigating local inflammation at the tumor site.

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References

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