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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Preoperative C-reactive protein as a prognostic and therapeutic marker for colorectal cancer
Yuhki Koike1, Chikao Miki, Yoshinaga Okugawa
1Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie, Japan. koikyon@clin.medic.mie-u.ac.jp
Background And Objectives:
This study aimed to evaluate the significance of preoperative C-reactive protein (CRP) as a prognostic marker for carcinoembryonic antigen (CEA)-independent stage I or II colorectal cancer (CRC) patients.
Methods:
Preoperative CRP was measured in 300 CRC patients to assess its relationships with clinicopathological factors and long-term survival. Based on the results of the initial study, the relationship between preoperative CRP and long-term survival was evaluated with reference to adjuvant 5-fluorouracil (5-FU)-based chemotherapy in a further 128 stage II patients.
Results:
CRP was associated with disease progression and factors reflecting nutritional depletion such as serum albumin, lymphocyte count and body weight loss ratio. In stage I or II patients, CRP could predict early disease recurrence, even when a CEA test could not. Multivariate analyses revealed that CRP was an independent prognostic variable in stage I or II patients. In the additional 128 stage II patients, CRP-positive patients showed a 3-year survival rate of only 55% without adjuvant chemotherapy, but this increased to 90% with adjuvant chemotherapy.
Conclusions:
CRP may be a potent prognostic and therapeutic indicator that provides valuable information for determining the need for adjuvant chemotherapy in stage II CRC patients.
