Cumulative Postoperative CRP Analysis on Prognosis in Esophageal Cancer Patients After Surgery

Background Blood cytokine levels (reflected by CRP values) affect the prognosis of esophageal cancer patients, We examined whether prognostic analysis of esophageal cancer patients could be performed by graphing postoperative CRP level trends and evaluating the area under the curve in addition to preoperative CRP levels. Methods 125 patients with esophageal squamous cell carcinoma were studied. The cut-off for preoperative CRP values was 0.28 mg/dL. CRP values over 14 days after surgery were graphed to create a trendline, and the area under the graph was calculated. The total CRP value for 7 days and 8–14 days were evaluated as CRP (7), CRPd. Cut-off CRP values were 59.9, and 56 mg/dL, respectively. The relationship between postoperative complications and CRP levels was also examined. The outcomes were overall survival (OS) and recurrence-free survival (RFS). The univariate and Cox analyses were used to analyze the prognostic factors. Results 1. The preoperative high CRP group had a significantly poorer OS (P = 0.009), but no difference was observed in RFS (P = 0.052). The prognosis of postoperative high CRP (7) was significantly poorer in both OS and RFS (P = 0.008, 0.009), but no significant difference was observed in CRPd. In univariate analysis (OS, RFS), TNM stage, tumor location, CRP (7), and preoperative CRP value were significant prognostic factors. In Cox analysis (OS), the stepwise method was performed and only preoperative CRP value was found to be a significant prognostic factor. In the analysis of RFS, tumor location was a significant prognostic factor. Conclusion 1. It is suggested that correcting preoperative CRP values may contribute to improving the prognosis of esophageal cancer patients. 2. Minimizing postoperative complications and suppressing CRP values one week after surgery may lead to improved patient prognosis.