TY - JOUR
T1 - C-reactive protein as an adverse prognostic marker for men with castration-resistant prostate cancer (CRPC)
T2 - Confirmatory results
AU - Prins, Renee C.
AU - Rademacher, Brooks L.
AU - Mongoue-Tchokote, Solange
AU - Alumkal, Joshi J.
AU - Graff, Julie N.
AU - Eilers, Kristine M.
AU - Beer, Tomasz M.
N1 - Funding Information:
The authors acknowledge support in part for this work by a generous donation from Robert and Diana Gerding. Biostatistics support was provided by the Biostatistics Shared Resource of the Knight Cancer Institute (NIH/NCI P30 CA069533).
PY - 2012/1
Y1 - 2012/1
N2 - We previously reported that higher serum concentrations of C-reactive protein (CRP) are associated with shorter survival in men with castration-resistant prostate cancer (CRPC). To confirm this finding in an independent data set, we used 119 CRPC patients enrolled in 6 phase II clinical trials and examined the relationship of CRP, alkaline phosphatase, hemoglobin, age, ECOG PS, and prostate specific antigen (PSA) with survival. Median follow-up was 19.7 months (0.9-98.5 months), and 89% have died. After analyzing the form of the risk function using the generalized additive model method, univariate and multivariate Cox proportional hazard models were used to assess associations between baseline individual categorical and continuous variables. Quartiles of CRP were: 0-1.0, 1.1-4.9, 5.0-17.0, and 17.1-311 mg/L. In a Cox multivariate model, log 2 (CRP) (HR 1.106, P = 0.013) as well as hemoglobin and alkaline phosphatase were independently associated with survival, confirming that higher CRP is associated with shorter survival in CRPC. Since CRP is a marker of inflammation, this finding suggests that inflammation may play an important role in the natural history of advanced prostate cancer. CRP is a readily measurable biomarker that has the potential to improve prognostic models and should be validated in a prospective clinical trial.
AB - We previously reported that higher serum concentrations of C-reactive protein (CRP) are associated with shorter survival in men with castration-resistant prostate cancer (CRPC). To confirm this finding in an independent data set, we used 119 CRPC patients enrolled in 6 phase II clinical trials and examined the relationship of CRP, alkaline phosphatase, hemoglobin, age, ECOG PS, and prostate specific antigen (PSA) with survival. Median follow-up was 19.7 months (0.9-98.5 months), and 89% have died. After analyzing the form of the risk function using the generalized additive model method, univariate and multivariate Cox proportional hazard models were used to assess associations between baseline individual categorical and continuous variables. Quartiles of CRP were: 0-1.0, 1.1-4.9, 5.0-17.0, and 17.1-311 mg/L. In a Cox multivariate model, log 2 (CRP) (HR 1.106, P = 0.013) as well as hemoglobin and alkaline phosphatase were independently associated with survival, confirming that higher CRP is associated with shorter survival in CRPC. Since CRP is a marker of inflammation, this finding suggests that inflammation may play an important role in the natural history of advanced prostate cancer. CRP is a readily measurable biomarker that has the potential to improve prognostic models and should be validated in a prospective clinical trial.
KW - C-reactive protein
KW - Inflammation
KW - Prognosis
KW - Prostate cancer
KW - Survival
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U2 - 10.1016/j.urolonc.2009.11.012
DO - 10.1016/j.urolonc.2009.11.012
M3 - Article
C2 - 20207556
AN - SCOPUS:84855691020
SN - 1078-1439
VL - 30
SP - 33
EP - 37
JO - Urologic Oncology: Seminars and Original Investigations
JF - Urologic Oncology: Seminars and Original Investigations
IS - 1
ER -