Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Oncology Letters
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-1074 Online ISSN: 1792-1082
Journal Cover
June 2013 Volume 5 Issue 6

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
June 2013 Volume 5 Issue 6

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article

Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment

  • Authors:
    • Yuji Toiyama
    • Hiroyuki Fujikawa
    • Yuki Koike
    • Susumu Saigusa
    • Yasuhiro Inoue
    • Koji Tanaka
    • Yasuhiko Mohri
    • Chikao Miki
    • Masato Kusunoki
  • View Affiliations / Copyright

    Affiliations: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie 514-8507, Japan
  • Pages: 1881-1888
    |
    Published online on: April 16, 2013
       https://doi.org/10.3892/ol.2013.1308
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

Lymph node status is the most significant prognostic factor of colorectal cancer. However, there is a risk of disease understaging if the extent of lymph node assessment is sub-optimal. Preoperative C-reactive protein (CRP) is known to be a useful tool in predicting postoperative outcomes in patients with colorectal cancer. We retrospectively evaluated whether CRP adds to prognosis information in stage I-III colorectal cancer patients with poor lymph node assessment. In stages I-III, multivariate analysis revealed that CRP-positive status and advanced T-stage were factors that independently affected survival. In stage III, univariate analysis revealed that lymph node number retrieval and lymph node ratio were factors that affected survival. However, CRP positivity was the only independent factor for survival. CRP positivity did not predict poor prognosis in stage II or III patients with adequate lymph node retrieval. By contrast, the prognosis of CRP-positive patients was poorer than that of CRP-negative patients in stage II and III, with inadequate lymph node retrieval. CRP is an independent prognostic marker in patients with stage I-III, II or III colorectal cancer. The evaluation of CRP may provide useful information on prognosis in curative patients with an inadequate examination of lymph nodes.
View Figures

Figure 1

Figure 2

Figure 3

Figure 4

View References

1 

Moertel CG: Chemotherapy for colorectal cancer. N Engl J Med. 330:1136–1142. 1994. View Article : Google Scholar : PubMed/NCBI

2 

Joseph NE, Sigurdson ER, Hanlon AL, et al: Accuracy of determining nodal negativity in colorectal cancer on the basis of the number of nodes retrieved on resection. Ann Surg Oncol. 10:213–218. 2003. View Article : Google Scholar : PubMed/NCBI

3 

Baxter NN, Virnig DJ, Rothenberger DA, Morris AM, Jessurun J and Virnig BA: Lymph node evaluation in colorectal cancer patients: a population-based study. J Natl Cancer Inst. 97:219–225. 2005. View Article : Google Scholar : PubMed/NCBI

4 

Chang GJ, Rodriguez-Bigas MA, Skibber JM and Moyer VA: Lymph node evaluation and survival after curative resection of colon cancer: systematic review. J Natl Cancer Inst. 99:433–441. 2007. View Article : Google Scholar : PubMed/NCBI

5 

Mamounas E, Wieand S, Wolmark N, et al: Comparative efficacy of adjuvant chemotherapy in patients with Dukes’ B versus Dukes’ C colon cancer: results from four National Surgical Adjuvant Breast and Bowel Project adjuvant studies (C-01, C-02, C-03, and C-04). J Clin Oncol. 17:1349–1355. 1999.

6 

Ratto C, Sofo L, Ippoliti M, et al: Accurate lymph-node detection in colorectal specimens resected for cancer is of prognostic significance. Dis Colon Rectum. 42:143–158. 1999. View Article : Google Scholar : PubMed/NCBI

7 

Caplin S, Cerottini JP, Bosman FT, Constanda MT and Givel JC: For patients with Dukes’ B (TNM stage II) colorectal carcinoma, examination of six or fewer lymph nodes is related to poor prognosis. Cancer. 83:666–672. 1998.

8 

Nelson H, Petrelli N, Carlin A, et al: Guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst. 93:583–596. 2001. View Article : Google Scholar : PubMed/NCBI

9 

Prandi M, Lionetto R, Bini A, et al: Prognostic evaluation of stage B colon cancer patients is improved by an adequate lymphadenectomy: results of a secondary analysis of a large scale adjuvant trial. Ann Surg. 235:458–463. 2002. View Article : Google Scholar

10 

Wong SL, Ji H, Hollenbeck BK, Morris AM, Baser O and Birkmeyer JD: Hospital lymph node examination rates and survival after resection for colon cancer. JAMA. 298:2149–2154. 2007. View Article : Google Scholar : PubMed/NCBI

11 

Noura S, Ohue M, Kano S, et al: Impact of metastatic lymph node ratio in node-positive colorectal cancer. World J Gastrointest Surg. 2:70–77. 2010. View Article : Google Scholar : PubMed/NCBI

12 

Nakazaki H: Preoperative and postoperative cytokines in patients with cancer. Cancer. 70:709–713. 1992. View Article : Google Scholar : PubMed/NCBI

13 

Nozoe T, Matsumata T, Kitamura M and Sugimachi K: Significance of preoperative elevation in serum C-reactive protein as an indicator for prognosis in colorectal cancer. Am J Surg. 176:335–338. 1998. View Article : Google Scholar : PubMed/NCBI

14 

Nozoe T, Matsumata T and Sugimachi K: Preoperative elevation of serum C-reactive protein is related to impaired immunity in patients with colorectal cancer. Am J Clin Oncol. 23:263–266. 2000. View Article : Google Scholar : PubMed/NCBI

15 

Gunter MJ, Stolzenberg-Solomon R, Cross AJ, et al: A prospective study of serum C-reactive protein and colorectal cancer risk in men. Cancer Res. 66:2483–2487. 2006. View Article : Google Scholar : PubMed/NCBI

16 

Miki C, Konishi N, Ojima E, Hatada T, Inoue Y and Kusunoki M: C-reactive protein as a prognostic variable that reflects uncontrolled up-regulation of the IL-1-IL-6 network system in colorectal carcinoma. Dig Dis Sci. 49:970–976. 2004. View Article : Google Scholar : PubMed/NCBI

17 

Koike Y, Miki C, Okugawa Y, et al: Preoperative C-reactive protein as a prognostic and therapeutic marker for colorectal cancer. J Surg Oncol. 98:540–544. 2008. View Article : Google Scholar : PubMed/NCBI

18 

Wiggers T, Arends JW, Schutte B, Volovics L and Bosman FT: A multivariate analysis of pathologic prognostic indicators in large bowel cancer. Cancer. 61:386–395. 1988. View Article : Google Scholar : PubMed/NCBI

19 

Fletcher RH: Carcinoembryonic antigen. Ann Int Med. 104:66–73. 1986. View Article : Google Scholar

20 

Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA and Tangen C: An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer. JAMA. 270:943–947. 1993. View Article : Google Scholar : PubMed/NCBI

21 

Tepper JE, O’Connell MJ, Niedzwiecki D, et al: Impact of number of nodes retrieved on outcome in patients with rectal cancer. J Clin Oncol. 19:157–163. 2001.PubMed/NCBI

22 

Joseph NE, Sigurdson ER, Hanlon AL, et al: Colon cancer survival is associated with increasing number of lymph nodes analyzed: A secondary survey of intergroup trial INT-0089. J Clin Oncol. 21:2912–2919. 2003. View Article : Google Scholar : PubMed/NCBI

23 

Swanson RS, Compton CC, Stewart AK and Bland KI: The prognosis of T3N0 colon cancer is dependent on the number of lymph nodes examined. Ann Surg Oncol. 10:65–71. 2003. View Article : Google Scholar : PubMed/NCBI

24 

Bilimoria KY, Palis B, Stewart AK, et al: Impact of tumor location on nodal evaluation for colon cancer. Dis Colon Rectum. 51:154–161. 2008. View Article : Google Scholar : PubMed/NCBI

25 

Leibl S, Tsybrovskyy O and Denk H: How many lymph nodes are necessary to stage early and advanced adenocarcinoma of the sigmoid colon and upper rectum? Virchows Arch. 443:133–138. 2003. View Article : Google Scholar : PubMed/NCBI

26 

Horzic M and Kopljar M: Minimal number of lymph nodes that need to be examined for adequate staging of colorectal cancer – factors influencing lymph node harvest. Hepatogastroenterology. 52:86–89. 2005.PubMed/NCBI

27 

AJCC Cancer Staging Manual. 6th edition. Springer; New York: 2002

28 

Le Voyer TE, Sigurdson ER, Hanlon AL, et al: Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol. 21:2912–2919. 2003.PubMed/NCBI

29 

Nitti D, Marchet A, Olivieri M, et al: Ratio between metastatic and examined lymph nodes is an independent prognostic factor after D2 resection for gastric cancer: analysis of a large European monoinstitutional experience. Ann Surg Oncol. 10:1077–1085. 2003. View Article : Google Scholar

30 

Voordeckers M, Vinh-Hung V, Van de Steene J, Lamote J and Storme G: The lymph node ratio as prognostic factor in node-positive breast cancer. Radiother Oncol. 70:225–230. 2004. View Article : Google Scholar : PubMed/NCBI

31 

Berger AC, Watson JC, Ross EA and Hoffman JP: The metastatic/examined lymph node ratio is an important prognostic factor after pancreaticoduodenectomy for pancreatic adenocarcinoma. Am Surg. 70:235–240. 2004.

32 

Inoue K, Nakane Y, Iiyama H, et al: The superiority of ratio-based lymph node staging in gastric carcinoma. Ann Surg Oncol. 9:27–34. 2002. View Article : Google Scholar : PubMed/NCBI

33 

Berger AC, Sigurdson ER, LeVoyer T, et al: Colon cancer survival is associated with decreasing ratio of metastatic to examined lymph nodes. J Clin Oncol. 23:8706–8712. 2005. View Article : Google Scholar : PubMed/NCBI

34 

Lee HY, Choi HJ, Park KJ, et al: Prognostic significance of metastatic lymph node ratio in node-positive colon carcinoma. Ann Surg Oncol. 14:1712–1717. 2007. View Article : Google Scholar : PubMed/NCBI

35 

Wang J, Hassett JM, Dayton MT and Kulaylat MN: Lymph node ratio: role in the staging of node-positive colon cancer. Ann Surg Oncol. 15:1600–1608. 2008. View Article : Google Scholar : PubMed/NCBI

36 

Rosenberg R, Friederichs J, Schuster T, et al: Prognosis of patients with colorectal cancer is associated with lymph node ratio: a single-center analysis of 3,026 patients over a 25-year time period. Ann Surg. 248:968–978. 2008.PubMed/NCBI

37 

Peng J, Xu Y, Guan Z, et al: Prognostic significance of the metastatic lymph node ratio in node-positive rectal cancer. Ann Surg Oncol. 15:3118–3123. 2008. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Toiyama Y, Fujikawa H, Koike Y, Saigusa S, Inoue Y, Tanaka K, Mohri Y, Miki C and Kusunoki M: Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment. Oncol Lett 5: 1881-1888, 2013.
APA
Toiyama, Y., Fujikawa, H., Koike, Y., Saigusa, S., Inoue, Y., Tanaka, K. ... Kusunoki, M. (2013). Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment. Oncology Letters, 5, 1881-1888. https://doi.org/10.3892/ol.2013.1308
MLA
Toiyama, Y., Fujikawa, H., Koike, Y., Saigusa, S., Inoue, Y., Tanaka, K., Mohri, Y., Miki, C., Kusunoki, M."Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment". Oncology Letters 5.6 (2013): 1881-1888.
Chicago
Toiyama, Y., Fujikawa, H., Koike, Y., Saigusa, S., Inoue, Y., Tanaka, K., Mohri, Y., Miki, C., Kusunoki, M."Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment". Oncology Letters 5, no. 6 (2013): 1881-1888. https://doi.org/10.3892/ol.2013.1308
Copy and paste a formatted citation
x
Spandidos Publications style
Toiyama Y, Fujikawa H, Koike Y, Saigusa S, Inoue Y, Tanaka K, Mohri Y, Miki C and Kusunoki M: Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment. Oncol Lett 5: 1881-1888, 2013.
APA
Toiyama, Y., Fujikawa, H., Koike, Y., Saigusa, S., Inoue, Y., Tanaka, K. ... Kusunoki, M. (2013). Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment. Oncology Letters, 5, 1881-1888. https://doi.org/10.3892/ol.2013.1308
MLA
Toiyama, Y., Fujikawa, H., Koike, Y., Saigusa, S., Inoue, Y., Tanaka, K., Mohri, Y., Miki, C., Kusunoki, M."Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment". Oncology Letters 5.6 (2013): 1881-1888.
Chicago
Toiyama, Y., Fujikawa, H., Koike, Y., Saigusa, S., Inoue, Y., Tanaka, K., Mohri, Y., Miki, C., Kusunoki, M."Evaluation of preoperative C-reactive protein aids in predicting poor survival in patients with curative colorectal cancer with poor lymph node assessment". Oncology Letters 5, no. 6 (2013): 1881-1888. https://doi.org/10.3892/ol.2013.1308
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team