Role of systemic inflammatory response in predicting survival in patients with primary operable cancer
Top Cited Papers
- 1 January 2010
- journal article
- review article
- Published by Future Medicine Ltd in Future Oncology
- Vol. 6 (1), 149-163
- https://doi.org/10.2217/fon.09.136
Abstract
Disease progression in cancer is dependent on the complex interaction between the tumor and the host inflammatory response. There is substantial evidence in advanced cancer that host factors, such as weight loss, poor performance status and the host systemic inflammatory response, are linked, and the latter is an important tumor-stage-independent predictor of outcome. Indeed, the systemic inflammatory response, as evidenced by an elevated level of C-reactive protein, is now included in the definition of cancer cachexia. This review examines the role of the systemic inflammatory response in predicting survival in patients with primary operable cancer. Approximately 80 studies have evaluated the role of the systemic inflammatory response using biochemical or hematological markers, such as elevated C-reactive protein levels, hypoalbuminemia or increased white cell, neutrophil and platelet counts. Combinations of such factors have been used to derive simple inflammation-based prognostic scores, such as the Glasgow Prognostic Score, the neutrophil:lymphocyte ratio and the platelet:lymphocyte ratio. This review demonstrates that there is now good evidence that preoperative measures of the systemic inflammatory response predict cancer survival, independent of tumor stage, in primary operable cancer. The evidence is particularly robust in colorectal (including liver metastases), gastro-esophageal and renal cancers. As described in this article, measurement of the systemic inflammatory response is simple, reliable and can be clinically incorporated into current staging algorithms. This will provide the clinician with a better prediction of outcome, and therefore better treatment allocation in patients with primary operable cancer. Furthermore, systemic inflammation-based markers and prognostic scores not only identify patients at risk, but also provide well-defined therapeutic targets for future clinical trials.This publication has 118 references indexed in Scilit:
- Neutrophil/lymphocyte ratio and its association with survival after complete resection in non–small cell lung cancerThe Journal of Thoracic and Cardiovascular Surgery, 2009
- Comparison of tumour-based (Petersen Index) and inflammation-based (Glasgow Prognostic Score) scoring systems in patients undergoing curative resection for colon cancerBritish Journal of Cancer, 2009
- Evaluation of the prognostic value of systemic inflammation and socioeconomic deprivation in patients with resectable colorectal liver metastasesEuropean Journal of Cancer, 2009
- Immune cells as mediators of solid tumor metastasisCancer and Metastasis Reviews, 2007
- Evaluation of the relationship between the systemic inflammatory response and cancer-specific survival in patients with primary operable breast cancerBritish Journal of Cancer, 2007
- Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancerInternational Journal of Colorectal Disease, 2007
- C-reactive protein as a predictor of prognosis following curative resection for colorectal liver metastasesBritish Journal of Cancer, 2007
- Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancerJournal of Surgical Oncology, 2005
- Inflammation and necrosis promote tumour growthNature Reviews Immunology, 2004
- Inflammation and cancerNature, 2002