Levels of Inflammation Markers Are Associated with the Risk of Recurrence and All-Cause Mortality in Patients with Colorectal Cancer

E. Wesselink*, M.G.J. Balvers, D.E. Kok, R.M. Winkels, M. van Zutphen, R.W.M. Schrauwen, E.T.P. Keulen, E.A. Kouwenhoven, S.O. Breukink, R.F. Witkamp, J.H.W. de Wilt, M.J.L. Bours, M.P. Weijenberg, E. Kampman, F.J.B. van Duijnhoven

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: We investigated whether preoperative and postoperative levels of inflammation markers, which have mechanistically been linked to colorectal cancer progression, were associated with recurrence and all-cause mortality in patients with colorectal cancer.Methods: Data of two prospective cohort studies were used. For the current analysis, patients with stage I to III colorectal cancer were considered. Data on inflammation [IL6, IL8, IL10, TNF alpha, high-sensitivity C-reactive protein (hsCRP), and a combined inflammatory z-score] were available for 747 patients before surgery and for 614 patients after surgery. The associations between inflammation marker levels and colorectal cancer recurrence and all-cause mortality were examined using multivariable Cox proportional hazard regression models, considering patient characteristics and clinical and lifestyle factors.Results: Higher preoperative and postoperative hsCRP levels were associated with a higher risk of recurrence [HRper doubling ( 95% CI), 1.15 (1.02-1.30) and 1.34 ( 1.16-1.55)] and all-cause mortality [HRper doubling (95% CI) 1.13 (1.01-1.28) and 1.15 (0.98-1.35)]. A doubling in IL8 levels (preoperative levels HR = 1.23; 95% CI, 1.00-1.53 and postoperative levels HR = 1.61; 95% CI, 1.23-2.12) and a higher combined inflammatory z-score (preoperative HRper doubling = 1.39; 95% CI, 1.03-1.89 and postoperative HRper doubling = 1.56; 95% CI, 1.06-2.28) were associated with a higher risk of all-cause mortality, but not recurrence. No associations between IL6, IL10, and TNF alpha and recurrence or all-cause mortality were observed.Conclusions: Preoperative and postoperative levels of specific inflammation markers were associated with recurrence and/or all-cause mortality.Impact: The complex role of inflammation in cancer recurrence merits further elucidation by investigating local inflammation at the tumor site.
Original languageEnglish
Pages (from-to)1089-1099
Number of pages11
JournalCancer Epidemiology Biomarkers & Prevention
Volume30
Issue number6
DOIs
Publication statusPublished - 1 Jun 2021

Keywords

  • C-REACTIVE PROTEIN
  • MOLECULAR PATHOLOGICAL EPIDEMIOLOGY
  • TUMOR-NECROSIS
  • VITAMIN-D
  • SERUM INTERLEUKIN-6
  • LIFE-STYLE
  • SURVIVAL
  • CYTOKINES
  • IMMUNITY
  • HEALTH

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