Postoperative C-reactive Protein Is a Predictive Biomarker for Survival After Non-small Cell Lung Cancer Resection

Abstract

Background/Aim: Preoperative C-reactive protein (CRP) is well recognized as a prognostic factor of non-small cell lung cancer (NSCLC). The present study aimed to elucidate the prognostic impact of postoperative CRP in patients with NSCLC following lung resection. Patients and Methods: We retrospectively reviewed 336 patients with NSCLC treated with lung resection. CRP levels were measured at postoperative week 6 (CRP 6w ; range: 4-8 weeks). Patients were divided into two groups based on CRP 6w median value (5.0 mg/l); the 5-year overall survival (OS) as well as the recurrence-free survival (RFS) was evaluated in both groups. Results: Five-year OS and RFS were worse in the high-CRP 6w group than in the low-CRP 6w group (62.9% vs. 82.9%; p<0.001, 48.4% vs. 76.1%; p<0.001, respectively). Subgroup analysis for pathological stage I and II also revealed worse OS in the high-CRP 6w group. Multivariate analysis revealed an association between high CRP 6w and worse OS (hazard ratio, 2.23; p<0.001). Conclusion: CRP 6w may serve as a prognostic biomarker in patients with resected NSCLC.