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Open Access Research article

Identification of prognostic inflammatory factors in colorectal liver metastases

Trevor D Hamilton1, Derek Leugner2, Karen Kopciuk2, Elijah Dixon1, Francis R Sutherland1 and Oliver F Bathe13*

Author Affiliations

1 Department of Surgery, University of Calgary, Calgary, AB, Canada

2 Department of Mathematics and Statistics, University of Calgary, Calgary, AB, Canada

3 Department of Oncology, University of Calgary, 1331-29th St NW, Calgary T2N 4N2, AB, Canada

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BMC Cancer 2014, 14:542  doi:10.1186/1471-2407-14-542

Published: 28 July 2014

Abstract

Background

The modified Glasgow Prognostic Score (mGPS) has been reported to be an important prognostic indicator in a number of tumor types, including colorectal cancer (CRC). The features of the inflammatory state thought to accompany elevated C-reactive protein (CRP), a key feature of mGPS, were characterized in patients with colorectal liver metastases. Additional inflammatory mediators that contribute to prognosis were explored.

Methods

In sera from 69 patients with colorectal liver metastases, a panel of 42 inflammatory mediators were quantified as a function of CRP levels, and as a function of disease-free survival. Multivariate statistical methods were used to determine association of each mediator with elevated CRP and truncated disease-free survival.

Results

Elevated CRP was confirmed to be a strong predictor of survival (HR 4.00, p = 0.001) and recurrence (HR 3.30, p = 0.002). The inflammatory state associated with elevated CRP was comprised of raised IL-1β, IL-6, IL-12 and IL-15. In addition, elevated IL-8 and PDGF-AB/BB and decreased eotaxin and IP-10 were associated with worse disease-free and overall survival.

Conclusions

Elevated CRP is associated with a proinflammatory state. The inflammatory state is an important prognostic indicator in CRC liver metastases. The individual contributions of tumor biology and the host to this inflammatory response will require further investigation.

Keywords:
Colorectal; Cancer; Liver; Metastases; Inflammatory; CRP; Cytokine; Prognostic; Surgery