Elevated preoperative C-reactive protein predicts poor cancer specific survival in patients undergoing resection for non-small cell lung cancer

O'Dowd, C., McRae, L.A., McMillan, D.C. , Kirk, A. and Milroy, R. (2010) Elevated preoperative C-reactive protein predicts poor cancer specific survival in patients undergoing resection for non-small cell lung cancer. Journal of Thoracic Oncology, 5(7), pp. 988-992. (doi:10.1097/JTO.0b013e3181da78f9)

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Abstract

Background: Although only the minority of patients with non-small cell lung cancer (NSCLC) are suitable for surgical resection, it offers the best possibility of cure. The aim of this study was to examine the relationship between the clinicopathological status, the preoperative systemic inflammatory response, and survival in patients undergoing potentially curative resection for NSCLC. Methods: Data from 96 patients who underwent resection of NSCLC between 2000 and 2003 were collected retrospectively and that for 2004-2006 prospectively. Results: All patients had Eastern cooperative oncology group performance status 0 or 1. No patient had T4, unresectable nodal or metastatic disease, and all macroscopic tumors were removed, with subsequent negative surgical margins. The majority of patients were older than 60 years (71%), men (57%), underwent a lobectomy (65%), and had tumor, node, metastasis stage I disease (66%). Of the markers of the systemic inflammatory response, white cell count, C-reactive protein, and albumin, only an elevated C-reactive protein (>10 mg/L) was associated with cancer-specific survival. On multivariate analysis, only tumor, node, metastasis stage (hazard ratio 1.88, 95% confidence interval 1.34-2.63, p < 0.001) and preoperative C-reactive protein (hazard ratio 1.67, 95% confidence interval 1.01-2.83, p < 0.05) retained independent significance. Those patients with a preoperative C-reactive protein concentration > 10 mg/L had a median survival of 26.2 months compared with 75.9 months in those patients with a C-reactive protein <= 10 mg/L (p < 0.05). Conclusion: The results of this study indicate that the presence of a systemic inflammatory response predicts poor outcome in patients who have undergone potentially curative resection for lung cancer

Item Type:Articles
Keywords:Albumin C-REACTIVE PROTEIN CANCER CHEMOTHERAPY COLORECTAL-CANCER CURATIVE RESECTION DISEASE INTERVAL Lung cancer LUNG-CANCER MARKERS MEN metastasis Non-small cell lung cancer outcome PATIENT patients PERFORMANCE PROGNOSTIC-FACTORS PROTEIN RATIO RESECTION SCORE Scotland SURGERY SURVIVAL SYSTEM SYSTEMIC INFLAMMATORY RESPONSE Tumor stage TUMORS WEIGHT-LOSS White cell count
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Milroy, Dr Robert and McMillan, Professor Donald
Authors: O'Dowd, C., McRae, L.A., McMillan, D.C., Kirk, A., and Milroy, R.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Journal of Thoracic Oncology
ISSN:1556-0864
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