title: The influence of elevated levels of C-reactive protein and hypoalbuminemia on survival in patients with advanced inoperable esophageal cancer undergoing palliative treatment.
abstract: OBJECTIVE
  Inflammation perpetuates individual tumor progression resulting in decreased survival in cancer patients. The aim of our study was to evaluate the influence of elevated levels of C-reactive protein (CRP) as well as low levels of albumin on patients with inoperable esophageal carcinoma.
  
  
  METHODS
  The data of 218 patients with advanced esophageal cancer, who were treated at a single center within 12 years, were evaluated retrospectively. Patient's age, gender, body weight, dysphagia, plasma levels of CRP and albumin, the Glasgow Prognostic Score (GPS) combining both indicators, and survival were assessed for statistical evaluation.
  
  
  RESULTS
  Thirty-nine (18.2%) had hypoalbuminemia and 161 (73.9%) had elevated CRP levels. Patients with hypoalbuminemia (P = 0.001) as well as patients with increased CRP levels (P = 0.001) showed a significantly shorter survival. Weight loss was correlated to elevated plasma CRP (P = 0.022), to diarrhea (P = 0.021), and to dysphagia (P = 0.008). Increasing GPS was significantly associated with poor survival (P = 0.001).
  
  
  CONCLUSIONS
  Elevated CRP levels and hypoalbuminemia are significantly associated with reduced survival and are considered to be an appropriate predictor for poor outcome in advanced esophageal carcinoma. The GPS provides additional detailed prognostication and should be therefore taken into consideration when the individual palliative strategy has to be scheduled.
authors: Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University Graz, Austria.
authors: Joerg
authors: J
authors: Lindenmann
authors: Nicole
authors: N
authors: Fink-Neuboeck
authors: Mario
authors: M
authors: Koesslbacher
authors: Martin
authors: M
authors: Pichler
authors: Tatjana
authors: T
authors: Stojakovic
authors: Regina Elisabeth
authors: RE
authors: Roller
authors: Alfred
authors: A
authors: Maier
authors: Udo
authors: U
authors: Anegg
authors: Josef
authors: J
authors: Smolle
authors: Freyja Maria
authors: FM
authors: Smolle-Juettner
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality / Q000628:therapy; D003680:Deglutition Disorders / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D004938:Esophageal Neoplasms / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D015431:Weight Loss; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein
keywords: C-reactive protein; advanced cancer; esophageal carcinoma; hypoalbuminemia; survival