title: Do preoperative serum C-reactive protein levels predict the definitive pathological stage in patients with clinically localized prostate cancer?
abstract: OBJECTIVE
  The serum C-reactive protein (CRP) level correlates with the clinical prognosis in patients with kidney, penile and metastatic castration-resistant prostate cancer (PC). We prospectively evaluated the preoperative CRP level as a predictive marker for an advanced tumor stage or high-grade cancer in patients with clinically localized PC.
  
  
  METHODS
  The study evaluated 629 patients with clinically localized PC who underwent radical prostatectomy between 2010 and 2013. Exclusion criteria were signs of systemic infection, symptoms of an autoimmune disease or neoadjuvant androgen deprivation.
  
  
  RESULTS
  Poorly differentiated PC tends to be more common in patients with elevated CRP levels (15.5 vs. 9.5%, p = 0.08). Analogously, patients with a Gleason score ≥8 PC had significantly higher median CRP levels than those with a Gleason score ≤7 PC (1.9 vs. 1.2 mg/l, p = 0.03). However, neither uni- nor multivariate analysis showed an association between the preoperative CRP level and the presence of a locally advanced tumor stage, lymph node metastases or a positive surgical margin. CRP also failed to correlate with the initial PSA level and the clinical tumor-associated findings. Moreover, multivariate analysis relativized the association between an elevated CRP level and poor tumor differentiation.
  
  
  CONCLUSIONS
  In patients with clinically localized PC, CRP does not appear to possess the predictive value and it was shown to have patients with other tumor entities or advanced PC.
authors: Department of Urology, Ulm University Medical Center, Prittwitzstrasse 43, 89075, Ulm, Germany, thomas.schnoeller@gmail.com.
authors: Thomas J
authors: TJ
authors: Schnoeller
authors: Julie
authors: J
authors: Steinestel
authors: Konrad
authors: K
authors: Steinestel
authors: Florian
authors: F
authors: Jentzmik
authors: Andres J
authors: AJ
authors: Schrader
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D051517:Digital Rectal Examination; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery
chemical_list: D002097:C-Reactive Protein; D017430:Prostate-Specific Antigen