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Elevated Preoperative Systemic Inflammatory Markers Predict Poor Outcome in Localized Soft Tissue Sarcoma

Annals of Surgical Oncology volume 21, pages 778–785 (2014)Cite this article

ABSTRACT

Background

Systemic inflammation has been implicated in cancer development and progression. This study sought to determine whether systemic inflammatory markers can predict postoperative outcome in soft tissue sarcoma (STS).

Methods

A total of 162 cases of primary, localized STS were reviewed. Patients with evidence of infectious or inflammatory diseases were excluded. The mean follow-up period was 46.7 months. The level of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and neutrophil-to-lymphocyte ratio (NLR) measured before surgery were evaluated for association with disease-specific survival and local recurrence.

Results

The mean values of CRP, ESR, and NLR were 0.79 mg/dL, 18.8 mm/h, and 2.12, respectively. Cutoff values derived from receiver-operating characteristic curve analysis were 0.20 mg/dL for CRP, 10.0 mm/h for ESR, and 2.50 for NLR. On univariate analysis, all inflammatory markers were associated with disease-specific survival (CRP: P = 0.007; ESR: P = 0.022; NLR: P = 0.030). On multivariate analysis, the CRP level (P = 0.019) and ESR (P = 0.013) remained significant. Elevation of multiple markers was a more significant prognostic factor than elevation of a single marker (P = 0.001). However, none of the inflammatory markers was associated with local recurrence (CRP: P = 0.345; ESR: P = 0.271; NLR: P = 0.570). Histologic grade was strongly correlated with inflammatory marker values (NLR: P < 0.001; ESR: P = 0.002; CRP: P = 0.007).

Conclusions

Preoperative systemic inflammatory status, assessed by using multiple serum markers, predicted disease-specific survival in STS.

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DISCLOSURE

The authors have declared no conflicts of interest or financial support.

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Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea

    Eun-Seok Choi MD, Han-Soo Kim MD, PhD & Ilkyu Han MD, PhD

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  1. Eun-Seok Choi MD
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  2. Han-Soo Kim MD, PhD
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Correspondence to Ilkyu Han MD, PhD.

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Choi, ES., Kim, HS. & Han, I. Elevated Preoperative Systemic Inflammatory Markers Predict Poor Outcome in Localized Soft Tissue Sarcoma. Ann Surg Oncol 21, 778–785 (2014). https://doi.org/10.1245/s10434-013-3418-3

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  • DOI: https://doi.org/10.1245/s10434-013-3418-3

Keywords

  • Erythrocyte Sedimentation Rate
  • Inflammatory Marker
  • Soft Tissue Sarcoma
  • Malignant Fibrous Histiocytoma
  • Trabectedin