Abstract 404P
Background
The presence of preoperative systemic inflammatory response (SIR) is an established negative prognostic factor for patients diagnosed with colorectal cancer (CRC). C-reactive protein (CRP) is known to be implicated in detrimental immune responses. The biological differences between right-sided and left-sided CRC are gaining increasing attention. Our aim was to analyse the prognostic value of CRP and explore the association between tumour sidedness and SIR.
Methods
2061 patients treated for stage I-III CRC, identified from the prospectively sampled ScotScan Collaborative dataset, were included. The clinical and prognostic value of five different CRP levels was examined (<10, 11-30, 31-60, 61-100 and >100 mg/l). Additionally, the relationship between SIR and tumour sidedness was explored.
Results
Increasing levels of CRP were associated with impaired overall and cancer-specific outcome. Presence of SIR was independently associated with right-sided tumour location (odds ratio [OR] 1.19, 95% CI 1.07-1.31). The impact of SIR on cancer-specific survival was greater for left-sided tumour location (hazard ratio [HR] 1.50, 95% CI 1.18-1.92), compared to the right (HR 1.28, 95% CI 1.00-1.64).
Conclusions
This study confirms CRP as an easy, valid and clinically relevant strong prognostic marker of SIR in CRC patients. Right-sided tumours were more often associated with SIR, but the prognostic impact was stronger in left-sided tumours.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Scholarship from Southern and Eastern Norway Regional Health Authority.
Disclosure
All authors have declared no conflicts of interest.