Prognostic and clinicopathological value of C-reactive protein in patients with bladder cancer: a meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of prognostic cohort studies
PubMed 39746669 · doi:10.1080/07853890.2024.2445781
What was done
A systematic review and meta-analysis of PubMed, Web of Science, Embase, and Cochrane Library databases searched up to April 19, 2024. The authors evaluated the prognostic and clinicopathological value of C-reactive protein (CRP) levels in bladder cancer patients using pooled hazard ratios (HRs) for survival outcomes and odds ratios (ORs) for clinicopathological variables with 95% confidence intervals (CIs).
What was found
Twenty studies comprising 7,276 patients were analyzed. Elevated CRP levels were significantly associated with worse overall survival (HR = 2.02, 95% CI = 1.41-2.90, p < .001), cancer-specific survival (HR = 1.46, 95% CI = 1.29-1.66, p < .001), recurrence-free survival (HR = 1.25, 95% CI = 1.17-1.33, p < .001), and progression-free survival (HR = 2.28, 95% CI = 1.80-2.90, p < .001). No significant relationship was found between CRP level and sex, tumour size, tumour grade, or lymph node metastasis (no numerical values reported in the abstract for these non-significant associations).
Why it matters
This meta-analysis demonstrates that elevated systemic CRP consistently correlates with shortened survival across multiple prognostic endpoints in bladder cancer, suggesting utility as a routine prognostic biomarker.
Limits
The included primary studies are observational cohorts prone to confounding and varying baseline patient characteristics. The abstract does not define the threshold cutoffs used to classify elevated CRP, does not stratify findings by cancer stage (non-muscle-invasive vs. muscle-invasive) or treatment received, and omits numerical effect sizes for clinicopathological associations.
Cited by
- supports Diets high in added sugars chronically elevate C-reactive protein (CRP), an inflammatory marker correlated with tumor progression and metastasis.