Systemic inflammatory response predicts survival following curative resection of colorectal cancer.
BACKGROUND
Some studies have shown that the presence of a systemic inflammatory response, as evidenced by raised circulating concentrations of C-reactive protein (CRP), predicted recurrence and overall survival in patients with colorectal cancer. The aim of this study was to examine the relationship between the inflammatory response and overall and cancer-specific survival in patients undergoing potentially curative resection for colorectal cancer.


METHODS
A total of 174 patients considered to have undergone curative resection were studied. Circulating CRP concentrations were measured before and/or after operation.


RESULTS
The majority of patients were aged 65 years or more, had colonic tumours and Dukes' stage B lesions. During follow-up, 47 patients (27 per cent) developed recurrence and 59 (34 per cent) died. On univariate analysis, age (P < 0.01), Dukes' stage (P < 0.001), and CRP levels before (P < 0.01) and after (P < 0.01) operation were significantly associated with overall and cancer-specific survival. On multivariate analysis of patients in whom preoperative CRP concentration was measured, age (P < 0.01), Dukes' stage (P < 0.05) and CRP concentration (P < 0.01) were independently associated with both overall and cancer-specific survival.


CONCLUSIONS
In patients who have undergone potentially curative resection for colorectal cancer, the presence of a systemic inflammatory response predicts a poor outcome.
McMillan
D C
DC
University Department of Surgery, Royal Infirmary, Glasgow G31 2ER, UK. d.c.mcmillan@clinmed.gla.ac.uk
Canna
K
K
McArdle
C S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000401:mortality; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology*
D002097:C-Reactive Protein