Abilities of Pre- and Postoperative High-Sensitivity C-Reactive Protein Levels to Predict 90-Day Mortality After Surgery for Abdominal and Thoracic Cancers
Background Elevated high-sensitivity C-reactive protein (hsCRP) levels are known to be associated with a poor prognosis for cancer patients, but inadequate data exist regarding whether pre- or postoperative hsCRP levels have better predictive value after oncologic surgery. This study evaluated the a...
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| Veröffentlicht in: | Annals of surgical oncology 2018-11, Vol.25 (12), p.3660-3666 |
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| creator | Oh, Tak Kyu Choi, YoungRok Oh, Ah-Young Chung, Seung Hyun Han, Sunghee Ryu, Jung-Hee |
| description | Background
Elevated high-sensitivity C-reactive protein (hsCRP) levels are known to be associated with a poor prognosis for cancer patients, but inadequate data exist regarding whether pre- or postoperative hsCRP levels have better predictive value after oncologic surgery. This study evaluated the associations between pre- and postoperative hsCRP levels and 90-day postoperative mortality among patients who underwent surgery for abdominal or thoracic cancers.
Methods
This retrospective cohort study included 7933 patients who underwent elective surgery between January 2010 and December 2016. Cox regression analysis and receiver operative characteristic curve analyses were used to evaluate the prognostic values of preoperative hsCRP ( |
| doi_str_mv | 10.1245/s10434-018-6734-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2099433053</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2098881357</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-ce805c0d6a7da4470edbe490aded032b022ed67176cf665d6c5c15c45540f4173</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhS1ERX_gAdggS2zYGOz4J8lyNECLNKijtqwtx75pXWXiwXZGmmfhZXFmCkhIXflI97vnyucg9JbRj6wS8lNiVHBBKGuIqotoX6AzJosQqmEvi6aqIW2l5Ck6T-mRUlZzKl-hU15Uw1txhn4tOj_47CHh0ON1BILN6PA6pBy2EE32O8BX_v6B3MKYCrjzeY-X5AaMPczWMWTwI17BDoaEc5hNnLcZt5R8Nnv8PcRshnlr0WeI-HaK9xD3uA8RLzoXNn40w-Ho3UOIxnqLl2a0ENNrdNKbIcGbp_cC_fj65W55RVbXl9-WixWxvK4ysdBQaalTpnZGiJqC60C01DhwlFcdrSpwqma1sr1S0ikrLZNWSCloL0okF-jD0Xcbw88JUtYbnywMgxkhTElXtG0FL8nxgr7_D30MUywfOFBN0zAuZ0N2pGwMKUXo9Tb6jYl7zaiem9PH5nRpTs_N6bbsvHtynroNuL8bf6oqQHUEUhmNJcJ_p593_Q2veaQw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2098881357</pqid></control><display><type>article</type><title>Abilities of Pre- and Postoperative High-Sensitivity C-Reactive Protein Levels to Predict 90-Day Mortality After Surgery for Abdominal and Thoracic Cancers</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Oh, Tak Kyu ; Choi, YoungRok ; Oh, Ah-Young ; Chung, Seung Hyun ; Han, Sunghee ; Ryu, Jung-Hee</creator><creatorcontrib>Oh, Tak Kyu ; Choi, YoungRok ; Oh, Ah-Young ; Chung, Seung Hyun ; Han, Sunghee ; Ryu, Jung-Hee</creatorcontrib><description>Background
Elevated high-sensitivity C-reactive protein (hsCRP) levels are known to be associated with a poor prognosis for cancer patients, but inadequate data exist regarding whether pre- or postoperative hsCRP levels have better predictive value after oncologic surgery. This study evaluated the associations between pre- and postoperative hsCRP levels and 90-day postoperative mortality among patients who underwent surgery for abdominal or thoracic cancers.
Methods
This retrospective cohort study included 7933 patients who underwent elective surgery between January 2010 and December 2016. Cox regression analysis and receiver operative characteristic curve analyses were used to evaluate the prognostic values of preoperative hsCRP (< 1 month before surgery) and postoperative hsCRP (< 3 days after surgery).
Results
For predicting 90-day mortality, the area under the receiver operating characteristic curve was significantly larger for preoperative hsCRP than for postoperative hsCRP [0.76; 95% confidence interval (CI) 0.71–0.81 vs 0.65 95% CI 0.57–0.72;
P
< 0.001]. The optimal cutoff values were 0.5 mg/dL for preoperative hsCRP and 9.7 mg/dL for postoperative hsCRP. Based on these cutoff values, increased risks of 90-day mortality were significantly associated with preoperative hsCRP levels higher than 0.5 mg/dL [hazard ratio (HR) 7.60; 95% CI 4.43–13.03;
P
< 0.001] and postoperative hsCRP levels higher than > 9.7 mg/dL (HR 1.83; 95% CI 1.12–2.98;
P
= 0.016).
Conclusion
Both elevated pre- and postoperative hsCRP levels were associated with increased risks of 90-day mortality after surgery for thoracic and abdominal cancer. However, preoperative hsCRP had better prognostic value than postoperative hsCRP.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-018-6734-9</identifier><identifier>PMID: 30178394</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdomen ; Abdominal Neoplasms - blood ; Abdominal Neoplasms - mortality ; Abdominal Neoplasms - pathology ; Abdominal Neoplasms - surgery ; Biomarkers, Tumor - blood ; C-reactive protein ; C-Reactive Protein - analysis ; Cancer ; Female ; Follow-Up Studies ; Health risk assessment ; Humans ; Lung cancer ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Oncology ; Postoperative Complications ; Postoperative period ; Preoperative Care ; Prognosis ; Retrospective Studies ; ROC Curve ; Surgery ; Surgical Oncology ; Survival Rate ; Thoracic Neoplasms - blood ; Thoracic Neoplasms - mortality ; Thoracic Neoplasms - pathology ; Thoracic Neoplasms - surgery ; Thoracic Oncology ; Thorax</subject><ispartof>Annals of surgical oncology, 2018-11, Vol.25 (12), p.3660-3666</ispartof><rights>Society of Surgical Oncology 2018</rights><rights>Annals of Surgical Oncology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-ce805c0d6a7da4470edbe490aded032b022ed67176cf665d6c5c15c45540f4173</citedby><cites>FETCH-LOGICAL-c372t-ce805c0d6a7da4470edbe490aded032b022ed67176cf665d6c5c15c45540f4173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-018-6734-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-018-6734-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30178394$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oh, Tak Kyu</creatorcontrib><creatorcontrib>Choi, YoungRok</creatorcontrib><creatorcontrib>Oh, Ah-Young</creatorcontrib><creatorcontrib>Chung, Seung Hyun</creatorcontrib><creatorcontrib>Han, Sunghee</creatorcontrib><creatorcontrib>Ryu, Jung-Hee</creatorcontrib><title>Abilities of Pre- and Postoperative High-Sensitivity C-Reactive Protein Levels to Predict 90-Day Mortality After Surgery for Abdominal and Thoracic Cancers</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Elevated high-sensitivity C-reactive protein (hsCRP) levels are known to be associated with a poor prognosis for cancer patients, but inadequate data exist regarding whether pre- or postoperative hsCRP levels have better predictive value after oncologic surgery. This study evaluated the associations between pre- and postoperative hsCRP levels and 90-day postoperative mortality among patients who underwent surgery for abdominal or thoracic cancers.
Methods
This retrospective cohort study included 7933 patients who underwent elective surgery between January 2010 and December 2016. Cox regression analysis and receiver operative characteristic curve analyses were used to evaluate the prognostic values of preoperative hsCRP (< 1 month before surgery) and postoperative hsCRP (< 3 days after surgery).
Results
For predicting 90-day mortality, the area under the receiver operating characteristic curve was significantly larger for preoperative hsCRP than for postoperative hsCRP [0.76; 95% confidence interval (CI) 0.71–0.81 vs 0.65 95% CI 0.57–0.72;
P
< 0.001]. The optimal cutoff values were 0.5 mg/dL for preoperative hsCRP and 9.7 mg/dL for postoperative hsCRP. Based on these cutoff values, increased risks of 90-day mortality were significantly associated with preoperative hsCRP levels higher than 0.5 mg/dL [hazard ratio (HR) 7.60; 95% CI 4.43–13.03;
P
< 0.001] and postoperative hsCRP levels higher than > 9.7 mg/dL (HR 1.83; 95% CI 1.12–2.98;
P
= 0.016).
Conclusion
Both elevated pre- and postoperative hsCRP levels were associated with increased risks of 90-day mortality after surgery for thoracic and abdominal cancer. However, preoperative hsCRP had better prognostic value than postoperative hsCRP.</description><subject>Abdomen</subject><subject>Abdominal Neoplasms - blood</subject><subject>Abdominal Neoplasms - mortality</subject><subject>Abdominal Neoplasms - pathology</subject><subject>Abdominal Neoplasms - surgery</subject><subject>Biomarkers, Tumor - blood</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - analysis</subject><subject>Cancer</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Oncology</subject><subject>Postoperative Complications</subject><subject>Postoperative period</subject><subject>Preoperative Care</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Thoracic Neoplasms - blood</subject><subject>Thoracic Neoplasms - mortality</subject><subject>Thoracic Neoplasms - pathology</subject><subject>Thoracic Neoplasms - surgery</subject><subject>Thoracic Oncology</subject><subject>Thorax</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc1u1DAUhS1ERX_gAdggS2zYGOz4J8lyNECLNKijtqwtx75pXWXiwXZGmmfhZXFmCkhIXflI97vnyucg9JbRj6wS8lNiVHBBKGuIqotoX6AzJosQqmEvi6aqIW2l5Ck6T-mRUlZzKl-hU15Uw1txhn4tOj_47CHh0ON1BILN6PA6pBy2EE32O8BX_v6B3MKYCrjzeY-X5AaMPczWMWTwI17BDoaEc5hNnLcZt5R8Nnv8PcRshnlr0WeI-HaK9xD3uA8RLzoXNn40w-Ho3UOIxnqLl2a0ENNrdNKbIcGbp_cC_fj65W55RVbXl9-WixWxvK4ysdBQaalTpnZGiJqC60C01DhwlFcdrSpwqma1sr1S0ikrLZNWSCloL0okF-jD0Xcbw88JUtYbnywMgxkhTElXtG0FL8nxgr7_D30MUywfOFBN0zAuZ0N2pGwMKUXo9Tb6jYl7zaiem9PH5nRpTs_N6bbsvHtynroNuL8bf6oqQHUEUhmNJcJ_p593_Q2veaQw</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Oh, Tak Kyu</creator><creator>Choi, YoungRok</creator><creator>Oh, Ah-Young</creator><creator>Chung, Seung Hyun</creator><creator>Han, Sunghee</creator><creator>Ryu, Jung-Hee</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20181101</creationdate><title>Abilities of Pre- and Postoperative High-Sensitivity C-Reactive Protein Levels to Predict 90-Day Mortality After Surgery for Abdominal and Thoracic Cancers</title><author>Oh, Tak Kyu ; Choi, YoungRok ; Oh, Ah-Young ; Chung, Seung Hyun ; Han, Sunghee ; Ryu, Jung-Hee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-ce805c0d6a7da4470edbe490aded032b022ed67176cf665d6c5c15c45540f4173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdomen</topic><topic>Abdominal Neoplasms - blood</topic><topic>Abdominal Neoplasms - mortality</topic><topic>Abdominal Neoplasms - pathology</topic><topic>Abdominal Neoplasms - surgery</topic><topic>Biomarkers, Tumor - blood</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - analysis</topic><topic>Cancer</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Lung cancer</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Oncology</topic><topic>Postoperative Complications</topic><topic>Postoperative period</topic><topic>Preoperative Care</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Thoracic Neoplasms - blood</topic><topic>Thoracic Neoplasms - mortality</topic><topic>Thoracic Neoplasms - pathology</topic><topic>Thoracic Neoplasms - surgery</topic><topic>Thoracic Oncology</topic><topic>Thorax</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oh, Tak Kyu</creatorcontrib><creatorcontrib>Choi, YoungRok</creatorcontrib><creatorcontrib>Oh, Ah-Young</creatorcontrib><creatorcontrib>Chung, Seung Hyun</creatorcontrib><creatorcontrib>Han, Sunghee</creatorcontrib><creatorcontrib>Ryu, Jung-Hee</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oh, Tak Kyu</au><au>Choi, YoungRok</au><au>Oh, Ah-Young</au><au>Chung, Seung Hyun</au><au>Han, Sunghee</au><au>Ryu, Jung-Hee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abilities of Pre- and Postoperative High-Sensitivity C-Reactive Protein Levels to Predict 90-Day Mortality After Surgery for Abdominal and Thoracic Cancers</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>25</volume><issue>12</issue><spage>3660</spage><epage>3666</epage><pages>3660-3666</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Elevated high-sensitivity C-reactive protein (hsCRP) levels are known to be associated with a poor prognosis for cancer patients, but inadequate data exist regarding whether pre- or postoperative hsCRP levels have better predictive value after oncologic surgery. This study evaluated the associations between pre- and postoperative hsCRP levels and 90-day postoperative mortality among patients who underwent surgery for abdominal or thoracic cancers.
Methods
This retrospective cohort study included 7933 patients who underwent elective surgery between January 2010 and December 2016. Cox regression analysis and receiver operative characteristic curve analyses were used to evaluate the prognostic values of preoperative hsCRP (< 1 month before surgery) and postoperative hsCRP (< 3 days after surgery).
Results
For predicting 90-day mortality, the area under the receiver operating characteristic curve was significantly larger for preoperative hsCRP than for postoperative hsCRP [0.76; 95% confidence interval (CI) 0.71–0.81 vs 0.65 95% CI 0.57–0.72;
P
< 0.001]. The optimal cutoff values were 0.5 mg/dL for preoperative hsCRP and 9.7 mg/dL for postoperative hsCRP. Based on these cutoff values, increased risks of 90-day mortality were significantly associated with preoperative hsCRP levels higher than 0.5 mg/dL [hazard ratio (HR) 7.60; 95% CI 4.43–13.03;
P
< 0.001] and postoperative hsCRP levels higher than > 9.7 mg/dL (HR 1.83; 95% CI 1.12–2.98;
P
= 0.016).
Conclusion
Both elevated pre- and postoperative hsCRP levels were associated with increased risks of 90-day mortality after surgery for thoracic and abdominal cancer. However, preoperative hsCRP had better prognostic value than postoperative hsCRP.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30178394</pmid><doi>10.1245/s10434-018-6734-9</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2018-11, Vol.25 (12), p.3660-3666 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdomen Abdominal Neoplasms - blood Abdominal Neoplasms - mortality Abdominal Neoplasms - pathology Abdominal Neoplasms - surgery Biomarkers, Tumor - blood C-reactive protein C-Reactive Protein - analysis Cancer Female Follow-Up Studies Health risk assessment Humans Lung cancer Male Medicine Medicine & Public Health Middle Aged Mortality Oncology Postoperative Complications Postoperative period Preoperative Care Prognosis Retrospective Studies ROC Curve Surgery Surgical Oncology Survival Rate Thoracic Neoplasms - blood Thoracic Neoplasms - mortality Thoracic Neoplasms - pathology Thoracic Neoplasms - surgery Thoracic Oncology Thorax |
| title | Abilities of Pre- and Postoperative High-Sensitivity C-Reactive Protein Levels to Predict 90-Day Mortality After Surgery for Abdominal and Thoracic Cancers |
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