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Baseline C-reactive protein level predicts survival of early-stage lung cancer: evidence from a systematic review and meta-analysis

Abstract

Purpose

The prognostic impact of baseline C-reactive protein (CRP) in non-small-cell lung cancer (NSCLC) is debated. To evaluate this issue, we performed a systematic review and meta-analysis to explore the role of CRP value in predicting early-stage NSCLC survival.

Methods

Ten articles on early-stage NSCLC were eligible and included in our study. We performed a random-effects meta-analysis and assessed heterogeneity and publication bias. We pooled hazard ratio (HR) estimates and their 95% confidence intervals (CIs) on mortality for the comparison between the study-specific highest category of CRP level versus the lowest one.

Results

In overall analysis, elevated pretreatment CRP values were significantly associated with poor overall survival (HR 1.60, 95% CI 1.30-1.97, p<0.001, I2 = 71.9%). Similar results were observed across considered strata. However, higher mortality risk was reported in studies in which CRP was combined with other factors (HR 1.96, 95% CI 1.58-2.45) and in those using a cutoff value of 3 mg/L (HR 1.89, 95% CI 1.52-2.35).

Conclusions

Based on our analysis, baseline high CRP level is significantly associated with poor prognosis in early-stage NSCLC. Further prospective controlled studies are needed to confirm these data.

Tumori 2016; 102(5): 441 - 449

Article Type: REVIEW

DOI:10.5301/tj.5000522

Authors

Giovanni Leuzzi, Carlotta Galeone, Mara Gisabella, Leonardo Duranti, Francesca Taverna, Paola Suatoni, Daniele Morelli, Ugo Pastorino

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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Authors

Affiliations

  • Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Department of Clinical Sciences and Community Health, University of Milan, Milan - Italy
  • Immunohematology and Transfusion Medicine Service, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy
  • Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy

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