title: C-reactive protein as a prognostic factor in patients with chordoma of lumbar spine and sacrum--a single center pilot study.
abstract: METHODS
  This is a retrospective, diagnostic study, level IV.
  
  
  BACKGROUND
  It appears to be necessary to identify prognostic markers for individual risk estimation for progression and survival in patients with chordoma, a rare disease. Are pre-operative serum levels of C-reactive protein (CRP) associated with disease progression and survival?
  
  
  METHODS
  Survival rates of 24 patients (18 males, 6 females) (mean age 67 years (SD ± 16; range 20-85 years); minimum follow-up 2 years, mean follow-up 5 years (SD ± 5; range 2-19 years)) with chordoma of the lower spine and sacrum were assessed with a focus on pre-operative CRP levels.
  
  
  RESULTS
  The survival rate of patients with pre-operative CRP level of >1.0 mg/dl was lower than that of patients with a CRP level <1.0 mg/dl (p = 0.01). The estimated 10-year survival of patients with pre-operative CRP values <1.0 and >1.0 mg/dl was 76 and 25%, respectively. CRP remained as an independent survival factor (p = 0.025; CI 95% 1.0-2.6) in multivariable analysis.
  
  
  CONCLUSIONS
  Pre-operative CRP levels appear to be a biomarker for disease-specific survival in patients with chordoma of the lumbar spine and sacrum. A validation of our finding with larger cohorts and integration of putative risk factor would further elucidate CRP a surrogate for tumor progression.
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090, Wien, Austria. gerhard.hobusch@meduniwien.ac.at.
authors.forename: Gerhard Martin
authors.initials: GM
authors.lastname: Hobusch
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090, Wien, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Bodner
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090, Wien, Austria.
authors.forename: Sonja
authors.initials: S
authors.lastname: Walzer
authors.affiliation: Department of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria.
authors.forename: Rodrig
authors.initials: R
authors.lastname: Marculescu
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090, Wien, Austria.
authors.forename: Philipp T
authors.initials: PT
authors.lastname: Funovics
authors.affiliation: Clinical institute of Pathology, Medical University of Vienna, Vienna, Austria.
authors.forename: Irene
authors.initials: I
authors.lastname: Sulzbacher
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090, Wien, Austria.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Windhager
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18 - 20, A-1090, Wien, Austria.
authors.forename: Joannis
authors.initials: J
authors.lastname: Panotopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D002817:Chordoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008159:Lumbar Vertebrae / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D010865:Pilot Projects; D011379:Prognosis; D012189:Retrospective Studies; D012447:Sacrum / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein
keywords: CRP; Chordoma; Inflammation; Prognostic marker; Recurrence; Resection margins; Survival