Significance of preoperative elevation of serum C-reactive protein as an indicator of prognosis in esophageal carcinoma

Background: Preoperative elevation of serum C-reactive protein (CRP) has be en reported to be a prognostic indicator in gastric carcinoma and colorecta l carcinoma. The aim of this study was to establish the significance of pre operative elevation of serum CRP as an indicator of prognosis in patients w ith esophageal carcinoma. Methods: Two hundred sixty-two patients with esophageal carcinoma who had b een treated by esophageal resection and reconstruction of digestive tracts were evaluated, excluding patients with neoplasms in other organs. Preopera tive serum CRP was measured, and the relation between the elevation of seru m CRP and the clinicopathological factors and prognosis of the patients was investigated. Results: The mean size of the tumors and the proportions of lymph node meta stasis and lymphatic invasion were significantly larger in patients with pr eoperative elevation of serum CRP than in patients without preoperative ele vation of serum CRP (5.8 +/- 2.5 cm versus 4.8 +/- 2.5 cm, P <0.01, 59.5% v ersus 35.4%, P <0.001, and 35.7% versus 23.6%, P <0.05, respectively). 1-, 3-, and 5-year survival rates in patients with preoperative elevation of se rum CRP (60.6%, 18.4%, and 11.5%, respectively) were significantly lower th an those in patients without preoperative elevation of serum CRP (88.7%, 70 .9%, and 68.4%, respectively; P <0.0001). Multivariate analysis demonstrate d that the preoperative elevation of serum CRP was an independent prognosti c factor in esophageal carcinoma (P <0.0001). Conclusions: The preoperative serum elevation of CRP can be a marker of the malignant potential of the tumor and an independent prognostic indicator i n esophageal carcinoma. (C) 2001 Excerpta Medica, Inc. All rights reserved.