The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Systemic inflammatory response predicts survival following curative resection of colorectal cancer. BJS 2003; 90: 215-219.

Published: 7th January 2003

Authors: D. C. McMillan, K. Canna, C. S. McArdle

Background

Some studies have shown that the presence of a systemic inflammatory response, as evidenced by raised circulating concentrations of C‐reactive protein (CRP), predicted recurrence and overall survival in patients with colorectal cancer. The aim of this study was to examine the relationship between the inflammatory response and overall and cancer‐specific survival in patients undergoing potentially curative resection for colorectal cancer.

Method

A total of 174 patients considered to have undergone curative resection were studied. Circulating CRP concentrations were measured before and/or after operation.

Results

The majority of patients were aged 65 years or more, had colonic tumours and Dukes' stage B lesions. During follow‐up, 47 patients (27 per cent) developed recurrence and 59 (34 per cent) died. On univariate analysis, age (P < 0·01), Dukes' stage (P < 0·001), and CRP levels before (P < 0·01) and after (P < 0·01) operation were significantly associated with overall and cancer‐specific survival. On multivariate analysis of patients in whom preoperative CRP concentration was measured, age (P < 0·01), Dukes' stage (P < 0·05) and CRP concentration (P < 0·01) were independently associated with both overall and cancer‐specific survival.

Conclusion

In patients who have undergone potentially curative resection for colorectal cancer, the presence of a systemic inflammatory response predicts a poor outcome. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd

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