Evaluation of the relationship between the systemic inflammatory response and cancer-specific survival in patients with primary operable breast cancer

The relationship between the systemic inflammatory response ( as evidenced by elevated C-reactive protein and lowered albumin concentrations), clinico-pathologic status and relapse-free, cancer-specific and overall survival was examined in patients with invasive primary operable breast cancer (n = 300). The median follow-up of the survivors was 46 months. During this period, 37 patients relapsed and 25 died of their cancer. On multivariate analysis, only tumour size (P < 0.05), albumin (P < 0.01) and systemic treatment (P < 0.0001) were significant independent predictors of relapse-free, cancer-specific and overall survival. Lower serum albumin concentrations (<= 43 gl(-1)) were associated with deprivation (P < 0.05), hormonal receptor negative tumours (P < 0.01) and significantly poorer 3-year relapse-free (85 vs 93%, P = 0.001) cancer-specific ( 87 vs 97%, P < 0.0001) and overall survival (84 vs 94%, P = 0.001) rates. The results of the present study suggest that lower preoperative albumin concentrations, but not elevated C-reactive protein concentrations, predict relapse-free, cancer-specific and overall survival, independent of clinico-pathologic status and treatment in patients undergoing potentially curative surgery for primary operable breast cancer.