The value of C-reactive protein as an independent prognostic indicator for disease-specific survival in patients with soft tissue sarcoma: A meta-analysis

by Xiaolin Wang, Song Liu, Xiaoli Zhao, Erhu Fang, Xiang Zhao

Serum C-reactive protein (CRP) level has been shown to be a predictor of survival for multiple cancer types. The aim of this study was to evaluate whether pretreatment serum CRP level could serve as a reliable independent prognostic indicator for survival in patients with soft tissue sarcoma (STS).

A detailed literature search was conducted in Medline, Embase and Cochrane for relevant research publications written in English. Patients’ clinical characteristics, outcomes of disease-specific survival (DSS) and disease/recurrence free survival (DFS/RFS) were extracted. Only the results of multivariate survival analysis were recruited in our analysis. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated to evaluate the prognostic role of CRP. This study was registered on PROPERO and the registration number is CRD42018104802.

Nine articles containing 1655 patients were identified as eligible studies. The random effects model showed that elevated CRP level was significantly correlated with poor DSS (HR = 2.08; 95% CI: 1.33–3.24; p < 0.001). After excluding the heterogeneous study, the fixed effects model showed that elevated CRP level was firmly correlated with poor DSS (HR = 2.36; 95% CI: 1.84–3.03; p < 0.001). The fixed effects model revealed that elevated CRP level was significantly correlated with poor DFS (HR = 1.78; 95% CI: 1.39–2.30; p < 0.001) among studies have more than 100 samples.

The results of this meta-analysis suggest that elevated pretreatment serum CRP level could serve as an independent risk factor for poor DSS and DFS/RFS in STS patents.