Abstract
Background: Blood level of C-reactive protein (CRP) at diagnosis is a well-know prognostic bio-marker in different primary tumors, but its role has not been investigated in resectable lung metastases. The aim of our study is to assess the predictive value of baseline (CRP0) and 3rd postoperative day (CRP3) levels on long-term survival of patients undergoing lung metastasectomy. Methods: A total of 846 consecutive patients underwent the first pulmonary resection for lung metastases between January 2003 and December 2015, including 611 (72%) single surgical procedures, 235 (28%) multiple metastasectomies, 501 (59%) epithelial primary tumors, 276 (33%) sarcomas, 66 (8%) melanomas, 286 (33.8%) with 0 risk factors (CRP0 ≤ 2 and CRP3 ≤ 84 mg/L) and 560 (66.2%) with ≥ 1 risk factor (CRP 0 > 2 and/or CRP 3 > 84 mg/L). Results: Cumulative 5-year survival was 57% in patients with low CRP (0 risk factors) versus 43% in high CRP (≥ 1 risk factor, p < 0.0002), 62% versus 50% respectively for epithelial tumors (p < 0.0140), and 51% versus 34% for sarcomas (p < 0.0111). Multivariable Cox analysis confirmed a mortality hazard ratio of 2.5 at 1-year and 1.5 at 5-years in patients with high CRP. Conclusions: Baseline and postoperative CRP levels predict survival of patients with resectable lung metastases. These data provide a rationale for prospective clinical trials testing the efficacy of anti-inflammatory or immune-modulating agents as “adjuvant” therapy after lung metastasectomy, in patients with elevated pre- and/or postoperative CRP levels.
| Original language | English |
|---|---|
| Pages (from-to) | 869-875 |
| Number of pages | 7 |
| Journal | Annals of Surgical Oncology |
| Volume | 26 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 15 2019 |
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ASJC Scopus subject areas
- Surgery
- Oncology
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Baseline and Postoperative C-reactive Protein Levels Predict Long-Term Survival After Lung Metastasectomy. / Pastorino, Ugo; Morelli, Daniele; Leuzzi, Giovanni; Rolli, Luigi; Suatoni, Paola; Taverna, Francesca; Bertocchi, Elena; Boeri, Mattia; Sozzi, Gabriella; Cantarutti, Anna; Corrao, Giovanni; Gronchi, Alessandro.
In: Annals of Surgical Oncology, Vol. 26, No. 3, 15.03.2019, p. 869-875.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Baseline and Postoperative C-reactive Protein Levels Predict Long-Term Survival After Lung Metastasectomy
AU - Pastorino, Ugo
AU - Morelli, Daniele
AU - Leuzzi, Giovanni
AU - Rolli, Luigi
AU - Suatoni, Paola
AU - Taverna, Francesca
AU - Bertocchi, Elena
AU - Boeri, Mattia
AU - Sozzi, Gabriella
AU - Cantarutti, Anna
AU - Corrao, Giovanni
AU - Gronchi, Alessandro
PY - 2019/3/15
Y1 - 2019/3/15
N2 - Background: Blood level of C-reactive protein (CRP) at diagnosis is a well-know prognostic bio-marker in different primary tumors, but its role has not been investigated in resectable lung metastases. The aim of our study is to assess the predictive value of baseline (CRP0) and 3rd postoperative day (CRP3) levels on long-term survival of patients undergoing lung metastasectomy. Methods: A total of 846 consecutive patients underwent the first pulmonary resection for lung metastases between January 2003 and December 2015, including 611 (72%) single surgical procedures, 235 (28%) multiple metastasectomies, 501 (59%) epithelial primary tumors, 276 (33%) sarcomas, 66 (8%) melanomas, 286 (33.8%) with 0 risk factors (CRP0 ≤ 2 and CRP3 ≤ 84 mg/L) and 560 (66.2%) with ≥ 1 risk factor (CRP 0 > 2 and/or CRP 3 > 84 mg/L). Results: Cumulative 5-year survival was 57% in patients with low CRP (0 risk factors) versus 43% in high CRP (≥ 1 risk factor, p < 0.0002), 62% versus 50% respectively for epithelial tumors (p < 0.0140), and 51% versus 34% for sarcomas (p < 0.0111). Multivariable Cox analysis confirmed a mortality hazard ratio of 2.5 at 1-year and 1.5 at 5-years in patients with high CRP. Conclusions: Baseline and postoperative CRP levels predict survival of patients with resectable lung metastases. These data provide a rationale for prospective clinical trials testing the efficacy of anti-inflammatory or immune-modulating agents as “adjuvant” therapy after lung metastasectomy, in patients with elevated pre- and/or postoperative CRP levels.
AB - Background: Blood level of C-reactive protein (CRP) at diagnosis is a well-know prognostic bio-marker in different primary tumors, but its role has not been investigated in resectable lung metastases. The aim of our study is to assess the predictive value of baseline (CRP0) and 3rd postoperative day (CRP3) levels on long-term survival of patients undergoing lung metastasectomy. Methods: A total of 846 consecutive patients underwent the first pulmonary resection for lung metastases between January 2003 and December 2015, including 611 (72%) single surgical procedures, 235 (28%) multiple metastasectomies, 501 (59%) epithelial primary tumors, 276 (33%) sarcomas, 66 (8%) melanomas, 286 (33.8%) with 0 risk factors (CRP0 ≤ 2 and CRP3 ≤ 84 mg/L) and 560 (66.2%) with ≥ 1 risk factor (CRP 0 > 2 and/or CRP 3 > 84 mg/L). Results: Cumulative 5-year survival was 57% in patients with low CRP (0 risk factors) versus 43% in high CRP (≥ 1 risk factor, p < 0.0002), 62% versus 50% respectively for epithelial tumors (p < 0.0140), and 51% versus 34% for sarcomas (p < 0.0111). Multivariable Cox analysis confirmed a mortality hazard ratio of 2.5 at 1-year and 1.5 at 5-years in patients with high CRP. Conclusions: Baseline and postoperative CRP levels predict survival of patients with resectable lung metastases. These data provide a rationale for prospective clinical trials testing the efficacy of anti-inflammatory or immune-modulating agents as “adjuvant” therapy after lung metastasectomy, in patients with elevated pre- and/or postoperative CRP levels.
UR - http://www.scopus.com/inward/record.url?scp=85059560317&partnerID=8YFLogxK
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U2 - 10.1245/s10434-018-07116-7
DO - 10.1245/s10434-018-07116-7
M3 - Article
C2 - 30607764
AN - SCOPUS:85059560317
VL - 26
SP - 869
EP - 875
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 3
ER -