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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate professor Camilla Qvortrup, University of Copenhagen,
- Second opponent: Associate professor Erik Koldberg Amundsen, OsloMet - Oslo Metropolitan University,
- Third member and chair of the evaluation committee: Associate professor Johannes K. Schultz, University of Oslo
Chair of the Defence
Associate professor Stephan Andreas Brackmann, University of Oslo
Principal Supervisor
Senior Consultant Christian Kersten, Akershus University Hospital
Summary
Colorectal cancer (CRC) is the second leading cause of cancer-related death globally, with Norway having among the highest incidence rates in the world. This warrants better understanding of factors that can distinguish patients who are cured of their cancer, from those who are not.
The presence of systemic inflammation is associated with poorer prognosis. C-reactive protein (CRP) is an easy way of measuring systemic inflammation and is included in routine blood tests. The aim of this thesis was to investigate the clinical and prognostic value of the CRP level in CRC patients undergoing curatively intended treatment.
By utilizing one of the world’s largest datasets within colorectal cancer and systemic inflammation, comprising more than 2000 patients, we could confirm the prognostic value of systemic inflammation in colorectal cancer patients. Our research demonstrates CRP alone as a feasible and strong prognostic marker of cancer-specific survival.
Further analyses showed associations between CRP and survival according to tumour location, in which CRP level has a greater prognostic impact for patients with left-sided colon cancer. Additionally, the CRP level can aid oncologists in evaluating the possibility of a co-existing infection in their patients.
Lastly, for the very first time, the pro-inflammatory CRP subunit; mCRP, was detected and measured in blood samples from colon cancer patients. We found that the level of circulating mCRP correlates with the amount of mCRP within the tumor tissue. This may indicate a reciprocal communication between local tumour-associated inflammation and systemic inflammation.
Altogether, the adverse prognostic value of systemic inflammation in colorectal cancer patients is explicit. The level of CRP can aid oncologists in the clinical evaluation of their patients. Further exploration of the biological roles of CRP could provide crucial new insight into both systemic and local inflammation.
Additional information
Contact the research support staff.