C-reactive protein as predictor of recurrence in patients with rectal cancer undergoing chemoradiotherapy followed by surgery.
BACKGROUND
The clinical significance of the systemic inflammatory response (SIR) in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy (CRT), to the best of our knowledge, has not been thus far investigated.


METHODS
The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and C-Reactive protein (CRP) levels for 84 patients with rectal cancer undergoing CRT were available as indicators of SIR status. The impact of SIR status on the prognosis of these patients was assessed.


RESULTS
Elevated NLR, CRP, carcinoembryonic antigen (CEA) and pathological TNM stage III [ypN(+)] were identified as significant prognostic factors for poor overall survival (OS), with CRP and ypN(+) being validated as independent predictors of OS. Elevated CRP and CEA levels were significant predictive factors for poor disease-free survival (DFS), and an elevated CRP level was identified as the only independent predictive factor for DFS. In addition, an elevated CRP level predicted for poorer OS and DFS in patients with pathological TNM stage I-II [ypN(-)].


CONCLUSIONS
CRP is a promising predictor of recurrence and prognosis in patients with rectal cancer treated by CRT.
Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie 514-8507, Japan. ytoi0725@clin.medic.mie-u.ac.jp.
Yuji
Y
Toiyama
Yasuhiro
Y
Inoue
Susumu
S
Saigusa
Mikio
M
Kawamura
Aya
A
Kawamoto
Yoshinaga
Y
Okugawa
Jyunichiro
J
Hiro
Koji
K
Tanaka
Yasuhiko
Y
Mohri
Masato
M
Kusunoki
D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002097:C-Reactive Protein / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D018279:Carcinoma, Signet Ring Cell / Q000378:metabolism / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology; D011379:Prognosis; D012004:Rectal Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D005641:Tegafur; D014498:Uracil; D002097:C-Reactive Protein; D005472:Fluorouracil
C-Reactive protein; chemoradiotherapy; neutrophil/lymphocyte ratio; platelet/lymphocyte ratio; prognosis; rectal cancer