{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T18:45:35Z","timestamp":1770489935873,"version":"3.49.0"},"reference-count":64,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The standard of care for the treatment of locally advanced rectal cancer is neoadjuvant chemoradiotherapy (nCRT) followed by surgery, but complete response rates are reduced. To find predictive biomarkers of response to therapy, we conducted a retrospective study evaluating blood biomarkers before nCRT. Hemoglobin (Hg), C-reactive protein (CRP), platelets, carcinoembryonic antigen, carbohydrate antigen 19.9 levels, and neutrophil\/lymphocyte ratio were obtained from 171 rectal cancer patients before nCRT. Patients were classified as responders (Ryan 0\u20131; ycT0N0), 59.6% (n = 102), or nonresponders (Ryan 2\u20133), 40.3% (n = 69), in accordance with the Ryan classification. A logistic regression using prognostic pretreatment factors identified CRP \u2264 3.5 (OR = 0.05; 95%CI: 0.01\u20130.21) as a strong independent predictor of response to treatment. Multivariate analysis showed that CRP was an independent predictor of disease-free survival (DFS) (HR = 5.48; 95%CI: 1.54\u201319.48) and overall survival (HR = 6.10; 95%CI 1.27\u201329.33) in patients treated with nCRT. Platelets were an independent predictor of DFS (HR = 3.068; 95%CI: 1.29\u20137.30) and OS (HR= 4.65; 95%CI: 1.66\u201313.05) and Hg was revealed to be an independent predictor of DFS (HR = 0.37; 95%CI: 0.15\u20130.90) in rectal cancer patients treated with nCRT. The lower expression of CRP is independently associated with an improved response to nCRT, DFS, and OS.<\/jats:p>","DOI":"10.3390\/cancers14030491","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T08:20:57Z","timestamp":1642580457000},"page":"491","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["C-Reactive Protein as Predictive Biomarker for Response to Chemoradiotherapy in Patients with Locally Advanced Rectal Cancer: A Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"given":"F\u00e1tima","family":"Aires","sequence":"first","affiliation":[{"name":"Radiotherapy Department of Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o (CHUSJ), 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8170-3952","authenticated-orcid":false,"given":"Darlene","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Radiotherapy Department of Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o (CHUSJ), 4200-319 Porto, Portugal"},{"name":"ICBAS\u2013Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal"},{"name":"CINTESIS\u2013Center for Health Technology and Services Research, University of Porto, 4200-450 Porto, Portugal"}]},{"given":"Mar\u00eda Pi\u00f1eiro","family":"Lamas","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health\u2013CIBERESP), 15706 Santiago de Compostela, Spain"},{"name":"Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0500-4049","authenticated-orcid":false,"given":"Maria Teresa","family":"Herdeiro","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Institute of Biomedicine\u2013iBiMED, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5766-8672","authenticated-orcid":false,"given":"Adolfo","family":"Figueiras","sequence":"additional","affiliation":[{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health\u2013CIBERESP), 15706 Santiago de Compostela, Spain"},{"name":"Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain"},{"name":"Faculty of Medicine, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0724-0272","authenticated-orcid":false,"given":"Maria Jos\u00e9","family":"Oliveira","sequence":"additional","affiliation":[{"name":"ICBAS\u2013Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal"},{"name":"i3S\u2013Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, University of Porto, 4200-135 Porto, Portugal"},{"name":"INEB\u2013Instituto de Engenharia Biom\u00e9dica, University of Porto, 4200-135 Porto, Portugal"}]},{"given":"Margarida","family":"Marques","sequence":"additional","affiliation":[{"name":"Radiotherapy Department of Centro Hospitalar Universit\u00e1rio de S\u00e3o Jo\u00e3o (CHUSJ), 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0974-2206","authenticated-orcid":false,"given":"Ana Teresa","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Institute of Biomedicine\u2013iBiMED, University of Aveiro, 3810-193 Aveiro, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,19]]},"reference":[{"key":"ref_1","first-page":"89","article-title":"Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors","volume":"14","author":"Rawla","year":"2019","journal-title":"Prz. 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