Postoperative Serum C-Reactive Protein Level Predicts Long-Term Outcomes in Stage I Gastric Cancer

Abstract Background The aim of this study was to investigate the prognostic impact of postoperative systemic inflammation in patients with stage I gastric cancer. Methods This study reviewed the medical records of 470 patients with stage I gastric cancer who underwent gastrectomy. The postoperative serum C-reactive protein (CRP) level on postoperative days (PODs) 1 and 3 and its peak value were evaluated as prognostic factors. A receiver operating characteristics curve analysis was performed to determine their cut-off values. Results The CRP level on POD 3 ( P  = 0.001) and the peak CRP level ( P  = 0.007) were significantly associated with the overall survival rate. In the multivariate analysis, the CRP level on POD 3 ( P  = 0.002) and the peak CRP level ( P  = 0.008) were identified as independent predictors of the overall survival. The high CRP on POD3 group had significantly higher mortality rate from relapse of gastric cancer ( P  = 0.001) and infectious disease ( P  = 0.003) than the low CRP on POD 3 group. The CRP level on POD 3 was significantly associated with the patient sex, surgical procedure, duration of the operation, amount of blood loss, postoperative infectious complication, and peak CRP level. Conclusions The serum CRP level during the early postoperative period predicts the long-term outcomes in stage I gastric cancer. The present study suggests a significant influence of postoperative systemic inflammation on the survival of patients with stage I gastric cancer.