1540P - The potential diagnostic role of procalcitonin for bacteremia in a large cohort of solid cancer patients

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Supportive measures
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Iacopo Fioroni
Citation Annals of Oncology (2014) 25 (suppl_4): iv517-iv541. 10.1093/annonc/mdu356
Authors I. Fioroni1, B. Vincenzi1, A. Zoccoli1, S. Angeletti1, L. De Florio1, D. Santini2, G. Dicuonzo1, A. Picardi2, M. Caricato2, G. Tonini3
  • 1Medical Oncology, university campus bio-medico, 00128 - rome/IT
  • 2Medical Oncology, Campus Bio-Medico University, 00128 - Rome/IT
  • 3Medical Oncology, University Campus Bio-Medico, 00128 - Rome/IT



In cancer patients (pts), commonly used systemic inflammatory response syndrome (SIRS) or sepsis diagnostic criteria lack of specificity, hence the importance to identificate an early useful diagnostic markers. Several studies showed procalcitonin (PCT) is a biomarker able to differentiate sepsis or bacterial infections from systemic non-infectious inflammatory syndrome. We studied the correlation between bacteremia and PCT levels in a large cohort of advanced solid cancer patients.


In this retrospective study we consecutively enrolled pts observed at Campus Bio-Medico University of Rome between January 2009 and March 2013. For all pts demographic/clinical data and laboratory parameters were collected. In particular all pts had a solid cancer diagnosis, fever (T>38.2 °C), PCT value and hemoculture results available before antibiotics. PCT was assessed in our central laboratory by an immunoluminometric assay; the normal reference range was 0-0,5 ng/dl. A ROC analysis was performed to measure predictive accuracy of PCT and the areas under the curves (AUC) were computed.


A total of 431 solid tumor pts were included: a cohort of 154 pts had positive blood culture and 277 negative. Pts were then divided into two groups according to PCT values (≤/>0,5 ng/dL): we observed that 160 pts had a PCT value≤0,5 ng/dL, while 271 >0,5 ng/dL. Among pts with PCT value≤0,5 ng/dL, Negative blood cultures were found in 128 pts while only 32 showed a positive one. Considering pts with PCT value >0,5 ng/dL, 149 showed a negative blood culture and 122 a positive one. Distributing pts according to Gram Positive (G+) or Negative (G-) bacteremia ROC analysis showed that the optimal cut-off value in G- infected pts was >2,23 (sensitivity: 65,7%, specificity:78,2%, AUC 0,771; P<0.001). In G+ and Fungi infection the best criterion was >4,06 (sensitivity: 32,1%, specificity: 85,8%, AUC= 0,575; P=0,082).


Serum PCT level can potentially be used as a diagnostic tool to exclude bacteremia with an higher sensitivity and specificity for G- infections and to inform critical management decisions regarding antibiotic usage, in solid tumor pts admitted with fever and suspected bloodstream infection.


All authors have declared no conflicts of interest.