C-reactive protein as prognostic marker in patients with p16-negative vs. p16-positive oropharyngeal squamous cell carcinoma

Background Elevated C-reactive protein (CRP) is associated with poor prognosis in several solid cancers. Reliable prognostic markers are lacking for papillomavirus (p16)-negative oropharyngeal squamous cell carcinoma (OPSCC). This study was performed to investigate the role of CRP in prognosis of patients with p16-positive oropharyngeal cancers compared with p16-negative oropharyngeal cancer. Methods: We retrospectively analyzed a set of 85 patients treated 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 regression models were used to determine overall survival and recurrence-free survival by CRP level in both populations.

Results Absolute CRP levels between p16-positive and p16 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 p16-negative group overall survival (OS) and recurrence-free survival (RFS) were significantly reduced in patients with elevated CRP levels (p<0.001 and p<0.001, respectively) in univariate and multivariate analysis. No significant differences in OS and DFS could be found with the p16-positive group. Conclusion: This study has shown that patient with p16 negative OPSCC and pretreatment elevated c-reactive protein showed a significant lower OS and RFS. Patients with p16 negative oropharyngeal carcinoma and elevated CRP level at 13,6 mg/L prior to therapy showed significantly reduced OS and RFS. Among p16 positive patients CRP levels were not significantly associated with OS or RFS.

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Publication History

Article published online:
10 June 2020