title: Clinical significance of pretreatment serum C-reactive protein level in soft tissue sarcoma.
abstract: BACKGROUND
  The aim of this study was to determine whether circulating C-reactive protein (CRP) levels before treatment predict the overall survival and disease-free survival in soft tissue sarcoma patients.
  
  
  METHODS
  A total of 102 primary soft tissue sarcoma patients from 2003 to 2009 were retrospectively reviewed. The CRP levels were obtained before treatment for all patients. The patients who presented with metastases at diagnosis were excluded from this study.
  
  
  RESULTS
  Elevated CRP levels were seen in 18 patients. The tumor histological grade and American Joint Committee on Cancer stage in the patients with elevated CRP levels were significantly higher than those in patients with normal CRP levels. Patients with elevated CRP levels before initial treatment had a poorer overall survival than patients with normal CRP levels (P = .01). The overall survival estimates at 3 and 5 years were 75.3% and 53.8%, respectively, versus 90.3% and 81.3%, respectively. Patients with elevated CRP levels before initial treatment had poorer event-free survival after initial treatment than patients with normal CRP levels (P < .001). The event-free survival estimates at 2 and 5 years were 53.2% and 33.2%, respectively, versus 83.2% and 81.3%, respectively. A multivariate analysis also showed the preoperative CRP level to be an independent predictor of events.
  
  
  CONCLUSIONS
  The pretreatment serum CRP level may be a marker of aggressive tumor characteristics. Pretreatment elevated CRP levels were found to be a poor prognostic factor for overall survival in a univariate analysis, and for disease-free survival in a multivariate analysis, for soft tissue sarcoma patients.
authors.affiliation: Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu City, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumine
authors.forename: Takao
authors.initials: T
authors.lastname: Matsubara
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Asanuma
authors.forename: Astumasa
authors.initials: A
authors.lastname: Uchida
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sudo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein