C-reactive protein with the survival outcomes of bladder cancer patients: a meta-analysis

Abstract Objectives Accumulating evidences suggested that serum C-reactive protein (CRP) was associated with the survival of bladder cancer patients. However, incongruent findings have been reported. Methods We comprehensively searched PubMed, Embase, and Web of science through August 2020 in order to find all eligible studies on the association between CRP and the overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS) of bladder cancer patients. The pooled hazard ratios (HRs) together with their 95% confidence intervals (CIs) were estimated by fixed-effect model if the heterogeneity was low, and random-effect model if the heterogeneity was high. A series of subgroup meta-analysis were performed with regard to the specific characteristics of study design. Results Thirteen eligible studies were included in this meta-analysis. The pooled results of 8 included studies revealed that an elevated CRP was associated with poor OS (HR = 2.24, 95% CI: 1.16–4.34) and CSS (HR = 1.53 95% CI: 1.36–1.72) of bladder cancer. Besides, the combined results of 3 included studies also indicated an inferior DFS for bladder cancer patients of elevated CRP level (HR = 2.07, 95% CI: 1.24–3.35). Subgroup analyses supported the robust association between elevated CRP and CSS. Conclusions These findings suggested that bladder cancer patients reported increase serum CRP had inferior prognostic outcomes.