C-reactive protein in patients with HPVp16-negative oropharyngeal squamous cell carcinoma. A single center retrospective study.
Description
Objectives: Elevated C-reactive protein (CRP) is associated with poor prognosis in several solid cancers. Reliable prognostic markers are lacking for papillomavirus (HPVp16)-negative oropharyngeal squamous cell carcinoma (OPSCC). This study was performed to investigate the role of CRP in prognosis of patients with HPVp16- negative oropharyngeal cancer. Design: We retrospectively analyzed data of 85 consecutive patients treated for OPSCC of a single center in Austria from 2013-2015. Information of performed examinations prior to treatment, CT and MR imaging, levels of C-reactive protein and fibrinogen, neutrophils and lymphocytes were retrospectively analyzed. Kaplan-Meier and Cox regression models were used to determine overall survival (OS) and recurrence-free survival (RFS) by CRP level in both populations. CRP cut-off Levels were defined by ROC curve at 13,6 mg/L. Results: Absolute CRP levels between HPVp16-positive and HPVp16-negative patients did not differ significantly. In the overall cohort elevated CRP levels (>13,6 mg/L) were associated with reduced overall survival (P=.01) and recurrence-free survival (P< .001). Within the HPVp16-negative group OS and RFS were significantly reduced in patients with elevated CRP levels (p<.001 and p<.001, respectively) in univariate and multivariate analysis, whereas no significant differences could be found with the HPVp16-positive group in OS and DFS. Conclusion: Patients with HPVp16-negative OPSCC and elevated CRP level at 13,6 mg/L prior to therapy showed significantly reduced OS and RFS, whereas among HPVp16-positive patients elevated CRP levels did not show any impact on OS or RFS.