Pre-operative serum C-reactive protein as independent prognostic factor for survival but not infection in patients with high-grade osteosarcoma.
OBJECTIVE
The purpose of this study was to investigate (a) whether pre-operative serum CRP is a predictor of survival in patients with high-grade osteosarcoma, (b) whether post-operative infection is a predictor of survival in these patients and (c) whether CRP is a predictor of post-operative infection, and especially deep prosthetic infection.


METHODS
In this retrospective single-centre study, pre-operative serum CRP levels in 79 patients (37 females, 42 males; average age, 18 years; mean follow-up, 46 months) undergoing resection of an osteosarcoma were correlated with clinical data and survival.


RESULTS
The mean pre-operative serum CRP level of all 79 patients was 0.53 mg/dl (SD, 1.27 mg/dl). Patients dying of their underlying disease had significantly higher CRP levels compared to patients surviving throughout the follow-up period (1.09 mg/dl ± 2.02 mg/dl versus 0.32 mg/dl ± 0.75 mg/dl, respectively; p = 0.015). CRP levels were significantly correlated with survival (Pearson's correlation coefficient = -0.25; p = 0.026) and histological subtype (Pearson's correlation coefficient = -0.42; p < 0.001), but not with sex, age, histological response, tumour size or metastatic disease. In uni- and multivariate survival analysis, age, response to chemotherapy and serum CRP were associated with disease-specific survival. Patients with a CRP level over 1 mg/dl had a significantly lower disease-specific five-year survival of 36.7% compared to 73.8% in patients with normal CRP values (p = 0.020). Infection was not correlated with disease-specific survival. Pre-operative serum CRP levels were not correlated with post-operative infection or deep prosthetic infection.


CONCLUSIONS
Pre-operative serum CRP seems to be an independent predictor of survival in patients with high-grade osteosarcoma. Further studies are needed to confirm these results on a large-scale basis.
Medical University of Vienna Department of Orthopaedic Surgery, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. philipp.funovics@meduniwien.ac.at
Philipp T
PT
Funovics
Gundula
G
Edelhauser
Martin A
MA
Funovics
Christoph
C
Laux
Dominik
D
Berzaczy
Bernd
B
Kubista
Rainer I
RI
Kotz
Martin
M
Dominkus
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001317:Austria / Q000453:epidemiology; D001859:Bone Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D057234:Preoperative Period; D011379:Prognosis; D016459:Prosthesis-Related Infections / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D013530:Surgical Wound Infection / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D015996:Survival Rate; D055815:Young Adult
D002097:C-Reactive Protein
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