Hilmy M et al. (2005) The relationship between the systemic inflammatory response and survival in patients with transitional cell carcinoma of the urinary bladder. Br J Cancer 92: 625–627

Evidence is mounting about the role of the systemic inflammatory response in cancer progression. A recent study published in the British Journal of Cancer explores its relationship with survival in 105 patients with transitional cell carcinoma of the urinary bladder.

C-reactive protein levels were determined in all patients before and/or after transurethral resection of the bladder tumor; elevated circulating concentrations of C-reactive protein (>10 mg/l) indicated a systemic inflammatory response. During the follow-up period, both preoperative and postoperative elevated C-reactive protein concentrations were significantly associated with overall survival, as were tumor stage and grade. A multivariate analysis of the 59 patients who had C-reactive protein levels measured preoperatively showed that elevated C-reactive protein was independently associated with cancer-specific survival (hazard ratio 3.31, 95% CI 1.09–10.09).

In summary, this study showed that the systemic inflammatory response, as indicated by elevated levels of C-reactive protein, predicted cancer-specific survival independently of tumor stage or grade. The authors discuss possible mechanisms by which this effect might be mediated and call for further studies in this area.