title: Roles of preoperative C-reactive protein are more relevant in buccal cancer than other subsites.
abstract: BACKGROUND
  C-reactive protein (CRP) is an early marker for inflammation, and a relationship between serum CRP levels and survival in oral cancer has been demonstrated previously. In this study, we investigated the roles of CRP in different oral cancer subsites.
  
  
  METHODS
  Three hundred and forty-three oral squamous cell carcinoma patients between June 1999 and March 2015 were retrospectively reviewed. Serum CRP levels were measured preoperatively.
  
  
  RESULTS
  The elevation of CRP levels (≥5.0 mg/L) was significantly correlated with pathologic tumor status, pathologic nodal status, nodal extracapsular spread, tumor stage, skin invasion, tumor depth (≥10 mm), and bone invasion. The correlation between elevation of CRP and clinicopathologic factors was more evident in the buccal cancer compared to other tumor subsites. The disease-free survival and overall survival correlation was significant in buccal cancer (p = 0.003 and p < 0.001) but not in tongue cancer (p = 0.119 and p = 0.341) or other oral cancer subsites (p = 0.246 and p = 0.696).
  
  
  CONCLUSIONS
  Preoperative serum CRP level was a prognosticator in oral squamous cell carcinoma, and its effect was more prominent in buccal cancer that occurs more frequently in areca-quid (AQ) endemic regions.
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan.|Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Shiao Fwu
authors.initials: SF
authors.lastname: Tai
authors.affiliation: Department of Public Health, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Huei-Tzu
authors.initials: HT
authors.lastname: Chien
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China.
authors.forename: Chi-Kuang
authors.initials: CK
authors.lastname: Young
authors.affiliation: Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China.
authors.forename: Chung-Kang
authors.initials: CK
authors.lastname: Tsao
authors.affiliation: Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China.
authors.forename: Alba
authors.initials: A
authors.lastname: de Pablo
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Kang-Hsing
authors.initials: KH
authors.lastname: Fan
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan.|Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.affiliation: Department of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan.|Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Joseph Tung-Chieh
authors.initials: JT
authors.lastname: Chang
authors.affiliation: Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou, Taiwan. bigmac@adm.cgmh.org.tw.|Department of Public Health, Chang Gung University, Taoyuan, Taiwan, Republic of China. bigmac@adm.cgmh.org.tw.
authors.forename: Shiang-Fu
authors.initials: SF
authors.lastname: Huang
mesh_terms: 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* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D009062:Mouth Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein
keywords: C-reactive protein; Oral squamous cell carcinoma; Prognosticator