Elevated Preoperative Serum C-Reactive Protein Levels are Associated with Poor Survival in Patients with Colorectal Cancer

Background/Aims: Previous studies have reported that elevated preoperative serum C-reactive protein (CRP) levels are associated with a poor prognosis in patients with various types of cancer. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP levels in patients with colorectal cancer and determine an appropriate cutoff value of the serum CRP level. Methodology: We enrolled 855 patients who underwent surgery for stage I-IV colorectal cancer. The median serum CRP level was 0.13 (range: 0.01-22.8). We set 0.6 as the cutoff value of the serum CRP level based on the receiver operating characteristic curve. The patients were classified into two groups according to the serum CRP level. The prognostic significance of an elevated serum CRP level was evaluated using a multivariate analysis. Results: The cancer-specific survival was significantly worse in the patients with a high serum CRP level. In particular, more significant differences were observed in the patients with stage IV disease. The multivariate analysis indicated that a high serum CRP level was an independent risk factor for poor survival. Conclusions: The preoperative serum CRP level is a convenient biomarker and predictor of a poor prognosis after surgery for colorectal cancer.