Systemic inflammatory response and survival in patients with localised prostate cancer: 10-year follow-up.
OBJECTIVE
To examine the prognostic value of circulating C-reactive protein concentrations at diagnosis in patients with organ-confined prostate cancer.


METHODS
Ninety-eight patients with histologically proven clinically localised prostate cancer were studied. Clinical stage, tumour grade, circulating PSA and C-reactive protein concentrations at diagnosis were recorded.


RESULTS
The majority of patients was under the age of 70 years and had low-grade tumours. Approximately half the patients received radical local treatment. During the follow-up period (median 10 years) 38 patients died, of whom 18 died of prostate cancer, 6 of other cancers and 14 of non-cancer causes. On univariate survival analysis, age (p < 0.001), Gleason score (p < 0.05), C-reactive protein (p < 0.05) and treatment (p < 0.05) were significant predictors of overall survival. On univariate survival analysis, age (p < 0.001), Gleason score (p < 0.05) and C-reactive protein (p < 0.05) were significant predictors of prostate cancer-specific survival. On multivariate analysis of these significant variables age (HR 4.88, 95% CI 1.79-13.29, p < 0.01), Gleason score (HR 2.16, 95% CI 1.23-3.78, p < 0.01) and C-reactive protein (HR 1.88, 95% CI 1.01-3.52, p < 0.05) remained significant independent predictors of prostate cancer-specific survival.


CONCLUSIONS
The results of the present study show that the presence of a systemic inflammatory response, at diagnosis, independently predicts poor long-term cancer outcome in patients with localised prostate cancer.
McArdle
Peter A
PA
University Department of Surgery, Faculty of Medicine, University of Glasgow, Royal Infirmary, Glasgow, UK. peters @ doctors.org.uk
Qayyum
Tahir
T
McMillan
Donald C
DC
D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D003430:Cross-Sectional Studies; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000276:immunology / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data*; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome
D018836:Inflammation Mediators; D002097:C-Reactive Protein; D017430:Prostate-Specific Antigen