C-Reactive Protein Level Predicts Survival Outcomes in Rectal Cancer Patients Undergoing Total Mesorectal Excision After Preoperative Chemoradiation Therapy

摘要

BackgroundSystemic inflammatory response, as measured by C-reactive protein (CRP), is associated with prognosis in various types of human malignancies. However, to the best of our knowledge, the clinical significance of CRP in patients with locally advanced rectal cancer that undergo preoperative chemoradiation has not been investigated in detail. This retrospective study validates CRP as a potential predictive marker for survival outcomes in rectal cancer patients.MethodsIn this study, we enrolled 125 patients that received total mesorectal excision after preoperative chemoradiation for rectal cancer between January 2003 and December 2010. We investigated the association between preoperative CRP and clinicopathological characteristics and assessed the prognostic value of CRP.ResultsThe median follow-up was 41months. Elevated CRP showed significant correlation with high histological grade (P=0.009) and cancer recurrence (P=0.027). The 5-year disease-free survival and cancer-specific survival were significantly lower in the elevated CRP group (P=0.001). Moreover, CRP was the strongest predictive factor for cancer-specific survival in multivariate analysis (P=0.001). In the subgroup analysis, elevated CRP was a significant prognostic factor in patients with node-positive disease (P=0.025) and was associated with poorer tumor regression (TRG4-5; P=0.011).ConclusionsThe results of our study suggest that preoperative CRP level shows prognostic significance in rectal cancer patients that have undergone chemoradiation. Therefore, preoperative CRP may help clinicians to identify patients that need additional therapy to reduce systemic failure.