Levels of Inflammation Markers Are Associated with the Risk of Recurrence and All-Cause Mortality in Patients with Colorectal Cancer

We investigated whether preoperative and postoperative levels of inflammation markers, which have mechanistically been linked to colorectal cancer progression, were associated with recurrence and all-cause mortality in patients with colorectal cancer. Data of two prospective cohort studies were used...

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Published in:Cancer epidemiology, biomarkers & prevention Vol. 30; no. 6; pp. 1089 - 1099
Main Authors: Wesselink, Evertine, Balvers, Michiel G J, Kok, Dieuwertje E, Winkels, Renate M, van Zutphen, Moniek, Schrauwen, Ruud W M, Keulen, Eric T P, Kouwenhoven, Ewout A, Breukink, Stephanie O, Witkamp, Renger F, de Wilt, Johannes H W, Bours, Martijn J L, Weijenberg, Matty P, Kampman, Ellen, van Duijnhoven, Fränzel J B
Format: Journal Article
Language:English
Published: United States 01-06-2021
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Summary:We investigated whether preoperative and postoperative levels of inflammation markers, which have mechanistically been linked to colorectal cancer progression, were associated with recurrence and all-cause mortality in patients with colorectal cancer. Data of two prospective cohort studies were used. For the current analysis, patients with stage I to III colorectal cancer were considered. Data on inflammation [IL6, IL8, IL10, TNFα, high-sensitivity C-reactive protein (hsCRP), and a combined inflammatory -score] were available for 747 patients before surgery and for 614 patients after surgery. The associations between inflammation marker levels and colorectal cancer recurrence and all-cause mortality were examined using multivariable Cox proportional hazard regression models, considering patient characteristics and clinical and lifestyle factors. Higher preoperative and postoperative hsCRP levels were associated with a higher risk of recurrence [HR (95% CI), 1.15 (1.02-1.30) and 1.34 (1.16-1.55)] and all-cause mortality [HR (95% CI) 1.13 (1.01-1.28) and 1.15 (0.98-1.35)]. A doubling in IL8 levels (preoperative levels HR = 1.23; 95% CI, 1.00-1.53 and postoperative levels HR = 1.61; 95% CI, 1.23-2.12) and a higher combined inflammatory -score (preoperative HR = 1.39; 95% CI, 1.03-1.89 and postoperative HR = 1.56; 95% CI, 1.06-2.28) were associated with a higher risk of all-cause mortality, but not recurrence. No associations between IL6, IL10, and TNFα and recurrence or all-cause mortality were observed. Preoperative and postoperative levels of specific inflammation markers were associated with recurrence and/or all-cause mortality. The complex role of inflammation in cancer recurrence merits further elucidation by investigating local inflammation at the tumor site.
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ISSN:1055-9965
1538-7755
DOI:10.1158/1055-9965.EPI-20-1752