Retrospective Study to Examine Prognostic Value of C-Reactive Protein in Patients With Surgically Resectable Non-Small-Cell Lung Cancer

Using a nationally representative sample of non-small cell lung cancer (NSCLC) patients who underwent surgery in the US, this retrospective study showed that elevated C-reactive protein (CRP) levels pre surgery were associated with a higher risk of NSCLC recurrence/death. A similar association between elevated CRP levels post surgery and NSCLC recurrence was observed. Findings highlight the role of inflammation -suppressing treatments for NSCLC. Background: This study evaluated the association between elevated C-reactive protein (CRP) and clinical outcomes among adults treated with surgery for non-small cell lung cancer (NSCLC) in the US. Materials and Methods: Adults with NSCLC who underwent lung cancer surgery and had >= 1 CRP measurement prior to, or > 1 month following, index surgery were identified in the Optum Clinformatics claims database. The association between elevated CRP ( > 10 mg/L) and risk of NSCLC recurrence/death was assessed separately during the 6 months before surgery (pre surgery cohort) and 2 years following surgery (post-surgery cohort) using multivariate regressions and Kaplan-Meier analysis. Results: After adjusting for baseline demographic and clinical characteristics among patients in the pre surgery cohort with index surgery between 2016 to 2020 (n = 104), the incidence rate ratio (IRR) for NSCLC recurrence between elevated vs. non-elevated CRP was 2.17 (95% confidence interval [CI] = 1.03-4.60; P = .04). In the post surgery cohort (n = 264), the adjusted IRR for disease recurrence (elevated vs. non-elevated CRP) was 2.22 (95% CI = 1.05-4.70; P = .04). In the pre surgery cohort, the odds of death were nearly two-fold (odds ratio [OR] = 1.91; 95% CI = 1.06-3.42; P = .03) among patients with elevated CRP. In the post surgery cohort, the OR was 1.62 (95% CI = 0.88-2.97; P = .12). Among those with persistently elevated CRP prior to surgery, there was a significant overall trend of increased CRP over the 5-year period. Conclusion: These results suppor t the association bet ween elevated CRP and a higher risk of NSCLC recurrence/death in pre-and postsurgery cohorts. This study may shed lights on inflammation-suppressing treatments in patients with NSCLC.