Serum C-reactive protein concentration and the prognosis of ductal adenocarcinoma of the head of pancreas

Abstract Background The prognostic role of serum C-reactive protein in pancreatic cancer has received increasing attention; however the confounding effects of biliary obstruction have not been addressed in previous studies. We sought to determine the prognostic importance of serum CRP prior to bilia...

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Published in:	European journal of surgical oncology Vol. 35; no. 6; pp. 605 - 610
Main Authors:	Pine, J.K, Fusai, K.G, Young, R, Sharma, D, Davidson, B.R, Menon, K.V, Rahman, S.H
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-06-2009
Subjects:	Adult Aged Aged, 80 and over C-reactive protein (CRP) C-Reactive Protein - analysis Carcinoma, Pancreatic Ductal - blood Carcinoma, Pancreatic Ductal - therapy Ductal adenocarcinoma of the pancreas Female Hematology, Oncology and Palliative Medicine Humans Male Middle Aged Pancreatic Neoplasms - blood Pancreatic Neoplasms - therapy Prognosis Retrospective Studies Surgery Survival Survival Analysis Ductal adenocarcinoma of the pancreas C-reactive protein (CRP) Prognosis Survival
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Summary:	Abstract Background The prognostic role of serum C-reactive protein in pancreatic cancer has received increasing attention; however the confounding effects of biliary obstruction have not been addressed in previous studies. We sought to determine the prognostic importance of serum CRP prior to biliary intervention in the prognosis of pancreatic adenocarcinoma. Methods A retrospective case note review of patients diagnosed with pancreatic cancer between 2001 and 2006. Clinical, radiological and biochemical criteria were correlated with overall survival. Patients were divided into: Group 1 who underwent potentially curative resection, and Group 2 with advanced unresectable disease managed non-surgically. Results In total, 199 patients were included (58 resected). The proportion of patients with biliary obstruction was equal in both groups. Serum CRP and serum bilirubin concentration at presentation were significantly higher among patients in Group 2 compared to Group 1 ( P values). On multivariate analysis, advancing age ( P = 0.012) and raised serum CRP concentration were independently associated with overall survival only in Group 2 patients ( P = 0.027, 95% CI 0.31–0.93). This association was independent of biliary tract obstruction. Conclusion Raised serum C-reactive protein concentration at the time of presentation of advanced pancreatic cancer carries a poor prognosis independent of biliary tract obstruction.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0748-7983 1532-2157
DOI:	10.1016/j.ejso.2008.12.002