title: C-reactive protein as a marker of melanoma progression.
abstract: OBJECTIVE
  To investigate the association between blood levels of C-reactive protein (CRP) in patients with melanoma and overall survival (OS), melanoma-specific survival (MSS), and disease-free survival.
  
  
  METHODS
  Two independent sets of plasma samples from a total of 1,144 patients with melanoma (587 initial and 557 confirmatory) were available for CRP determination. Kaplan-Meier method and Cox regression were used to evaluate the relationship between CRP and clinical outcome. Among 115 patients who underwent sequential blood draws, we evaluated the relationship between change in disease status and change in CRP using nonparametric tests.
  
  
  RESULTS
  Elevated CRP level was associated with poorer OS and MSS in the initial, confirmatory, and combined data sets (combined data set: OS hazard ratio, 1.44 per unit increase of logarithmic CRP; 95% CI, 1.30 to 1.59; P < .001; MSS hazard ratio, 1.51 per unit increase of logarithmic CRP; 95% CI, 1.36 to 1.68; P < .001). These findings persisted after multivariable adjustment. As compared with CRP < 10 mg/L, CRP ≥ 10 mg/L conferred poorer OS in patients with any-stage, stage I/II, or stage III/IV disease and poorer disease-free survival in those with stage I/II disease. In patients who underwent sequential evaluation of CRP, an association was identified between an increase in CRP and melanoma disease progression.
  
  
  CONCLUSIONS
  CRP is an independent prognostic marker in patients with melanoma. CRP measurement should be considered for incorporation into prospective studies of outcome in patients with melanoma and clinical trials of systemic therapies for those with melanoma.
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Shenying
authors.initials: S
authors.lastname: Fang
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Yuling
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Dawen
authors.initials: D
authors.lastname: Sui
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Huey
authors.initials: H
authors.lastname: Liu
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Merrick I
authors.initials: MI
authors.lastname: Ross
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Gershenwald
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Janice N
authors.initials: JN
authors.lastname: Cormier
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Royal
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lucci
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Schacherer
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Gardner
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: John D
authors.initials: JD
authors.lastname: Reveille
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Roland L
authors.initials: RL
authors.lastname: Bassett
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Li-E
authors.initials: LE
authors.lastname: Wang
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Qingyi
authors.initials: Q
authors.lastname: Wei
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH.
authors.forename: Christopher I
authors.initials: CI
authors.lastname: Amos
authors.affiliation: Shenying Fang, Yuling Wang, Dawen Sui, Huey Liu, Merrick I. Ross, Jeffrey E. Gershenwald, Janice N. Cormier, Richard E. Royal, Anthony Lucci, Christopher W. Schacherer, Julie M. Gardner, Roland L. Bassett, Li-E Wang, and Jeffrey E. Lee, University of Texas MD Anderson Cancer Center; John D. Reveille, University of Texas Health Science Center at Houston, Houston, TX; Qingyi Wei, Duke University School of Medicine, Durham, NC; and Christopher I. Amos, Geisel College of Medicine, Dartmouth College, Lebanon, NH. jelee@mdanderson.org.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D004273:DNA, Neoplasm / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000235:genetics / Q000473:pathology; D008875:Middle Aged; D016016:Proportional Hazards Models
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D002097:C-Reactive Protein