The impact of preoperative serum C-reactive protein on the prognosis of patients with hepatocellular carcinoma.
BACKGROUND
The authors evaluated the significance of the preoperative serum C-reactive protein (CRP) level as a prognostic indicator in patients with hepatocellular carcinoma (HCC).


METHODS
One hundred forty-one patients who underwent curative resection for HCC were reviewed retrospectively. Clinicopathologic variables were compared between patients with serum CRP levels >/= 1.0 mg/dL (n = 22 patients; the CRP-positive group) and patients with serum CRP levels < 1.0 mg/dL (n = 119 patients; the CRP-negative group). Univariate and multivariate analyses were conducted to identify factors that affected survival and disease recurrence.


RESULTS
There was a significant correlation between the preoperative serum CRP level and tumor size. Invasion to the portal vein in the CRP-positive group was significantly more frequent than that in the CRP-negative group. Even after they underwent curative resection, 75.3% of patients in the CRP-positive group experienced recurrence within 1 year. The overall survival and recurrence-free survival rates in the CRP-positive group were significantly lower compared with the rates in the CRP-negative group. On multivariate analysis, the preoperative serum CRP level was selected as one of the unfavorable indicators regarding survival and recurrence. When CRP levels, albumin levels, and platelet counts that were available before surgery were scored as a combined index, the total score demonstrated a good stratification value for survival after hepatic resection.


CONCLUSIONS
The current results showed that the preoperative serum CRP level is an independent and significant indicator predictive of poor prognosis and early recurrence in patients with HCC. The new CRP-based scoring system offers reliable information for predicting survival.
Hashimoto
Koji
K
Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan. hkoji1969@yahoo.co.jp
Ikeda
Yasuharu
Y
Korenaga
Daisuke
D
Tanoue
Kazuo
K
Hamatake
Motoharu
M
Kawasaki
Katsumi
K
Yamaoka
Terutoshi
T
Iwatani
Yasue
Y
Akazawa
Kohei
K
Takenaka
Kenji
K
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D002097:C-Reactive Protein