The prognostic significance of pretherapeutic C-reactive protein (CRP) in head and neck cancer

Several immunological parameters have been proposed as prognostic indicators for squamous cell carcinomas of head and neck, potentially contributing, alongside conventional UICC classification, to the assessment of disease progression and survival prognosis. Aim of this study is to investigate the level of the CRP as a prognostic factor for the overall survival of patients with head and neck carcinoma. Data were collected from all patients with head and neck carcinomas treated at the ENT Clinic of the University Hospital in Giessen, Germany between 2009 and 2020. The date of diagnosis, pretherapeutic CRP level, UICC stage, and the date of the last follow-up or death were extracted. Based on pretherapeutic CRP levels, patients were divided into two groups (CRP≤5 mg/l, CRP>5 mg/l). Kaplan-Meier survival curves were created for each UICC stage (I-IVc) and the statistical significance was calculated. A total of 1183 patients were included. Patients with pretherapeutic CRP≤5 mg/l exhibited a statistically significant longer survival for tumor stages III, IVa, and IVb (III: n=250, p=0.04; IVa: n=423, p=3e-04; IVb: n=68, p=0.04). No statistically significant longer survival was observed for patients with tumor stages I, II, and IVc. The results suggest that pretherapeutic CRP levels could serve as a promising prognostic marker in patients with head and neck carcinomas, particularly in advanced tumor stages. This underlines the importance of inflammatory reactions in tumor development and progression, potentially improving the prognosis and management of these patients. Further prospective studies are necessary to confirm the clinical utility of CRP as a prognostic marker.