Prognostic Influence of Postoperative CRP Levels After Thoracoscopic Esophagectomy in Patients With Escc

Background Elevated serum levels of C-reactive protein (CRP) have been reported to be associated with a poor prognosis in patients with a variety of malignant tumors. In our previous work, we demonstrated that postoperative CRP levels can effectively predict prognosis in patients diagnosed with esophageal squamous cell carcinoma (ESCC) following esophagectomy with thoracotomy. The objective of this study was to rigorously evaluate the prognostic significance of the postoperative CRP level on the survivaloutcomes of patients with ESCC after they underwent thoracoscopic esophagectomy. Methods We conducted a retrospective review of the medical records of 170 consecutive patients with ESCC who underwent thoracoscopic esophagectomy. Serial measurements of postoperative serum CRP levels were obtained on postoperative days (POD) 1, 2, 3, 5, 7, 10, and 14. We then evaluated the relationship between these postoperative CRP levels and the overall surgical outcome. Results Cox proportional hazard regression analyses indicated that elevated CRP levels measured on POD 7, 10, and 14 were significantly associated with poor recurrence-free survival (RFS). When a cutoff value of 4.0 mg/dL was used for the CRP level on POD 7 (CRP day7), patients’ RFS could be stratified (p = 0.013). Multivariate analysis revealed that induction therapy (HR, 1.985; p = 0.015) and advanced pathological stage (HR, 2.667; p = 0.001) were independent predictors for RFS. While elevated CRP day 7 (HR, 1.652; p = 0.057) demonstrated a similar trend toward predicting poorer RFS. Conclusion Our findings demonstrate that CRP levels can effectively predict prognosis in patients with ESCC. Therefore, we propose that careful monitoring of postoperative CRP levels should be considered as a valuable prognostic tool for assessing survival outcomes in these patients.