C-reactive protein as predictor of recurrence in patients with rectal cancer undergoing chemoradiotherapy followed by surgery

• Published in: Anticancer research 2013-11, Vol.33 (11), p.5065-5074
• Main Authors: Toiyama, Yuji, Inoue, Yasuhiro, Saigusa, Susumu, Kawamura, Mikio, Kawamoto, Aya, Okugawa, Yoshinaga, Hiro, Jyunichiro, Tanaka, Koji, Mohri, Yasuhiko, Kusunoki, Masato
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - metabolism; Adenocarcinoma, Mucinous - mortality; Adenocarcinoma, Mucinous - secondary; Adenocarcinoma, Mucinous - therapy; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - analysis; C-Reactive Protein - metabolism; Carcinoembryonic Antigen - metabolism; Carcinoma, Signet Ring Cell - metabolism; Carcinoma, Signet Ring Cell - mortality; Carcinoma, Signet Ring Cell - secondary; Carcinoma, Signet Ring Cell - therapy; Chemoradiotherapy; Combined Modality Therapy; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Humans; Lymphocytes - pathology; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Neutrophils - pathology; Prognosis; Rectal Neoplasms - metabolism; Rectal Neoplasms - mortality; Rectal Neoplasms - pathology; Rectal Neoplasms - therapy; Survival Rate; Tegafur - administration & dosage; Uracil - administration & dosage
• ISSN: 1791-7530

The clinical significance of the systemic inflammatory response (SIR) in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy (CRT), to the best of our knowledge, has not been thus far investigated. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and C-Reactive protein (CRP) levels for 84 patients with rectal cancer undergoing CRT were available as indicators of SIR status. The impact of SIR status on the prognosis of these patients was assessed. Elevated NLR, CRP, carcinoembryonic antigen (CEA) and pathological TNM stage III [ypN(+)] were identified as significant prognostic factors for poor overall survival (OS), with CRP and ypN(+) being validated as independent predictors of OS. Elevated CRP and CEA levels were significant predictive factors for poor disease-free survival (DFS), and an elevated CRP level was identified as the only independent predictive factor for DFS. In addition, an elevated CRP level predicted for poorer OS and DFS in patients with pathological TNM stage I-II [ypN(-)]. CRP is a promising predictor of recurrence and prognosis in patients with rectal cancer treated by CRT.