Elevated CRP Linked to Increased Risk of Death and Disease Progression in Melanoma Patients: Meta-Analysis
China: A new meta-analysis published in Annals of Medicine has identified elevated C-reactive protein (CRP) levels as a strong indicator of poor outcomes in patients with melanoma. Conducted by Xuejia Xing and Zhixiang Fang from the Clinical Laboratory of Changxing People’s Hospital in Huzhou, Zhejiang, China, the study consolidates existing research to assess the true prognostic value of CRP in melanoma management.
"Meta-analysis of 19 studies has confirmed that elevated levels of CRP are strongly associated with poorer outcomes in patients with melanoma. The analysis revealed that individuals with high CRP levels face a twofold increased risk of overall mortality (HR 2.26) and an 84% higher risk of disease progression or death (PFS, HR 1.84)," the authors reported.
"These associations remained consistent across various patient subgroups, highlighting the potential of CRP as a reliable and clinically useful prognostic marker in the management of melanoma."
Melanoma, a severe form of skin cancer, often presents challenges in predicting disease progression and survival outcomes. While CRP—a marker of systemic inflammation—has been examined in previous studies for its prognostic role, the results have varied considerably. This prompted the researchers to conduct a comprehensive meta-analysis to determine the reliability of CRP as a clinical marker in melanoma patients.
For this purpose, the researchers searched major databases, including PubMed, Web of Science, Embase, and the Cochrane Library up to January 25, 2025. A total of 19 studies involving 4,634 patients were included. The investigators calculated pooled hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the relationship between CRP levels and patient outcomes, specifically overall survival (OS) and progression-free survival.
The following were the key findings of the study:
- Patients with elevated CRP levels had more than twice the risk of death from melanoma (HR 2.26).
- These patients also faced an 84% higher risk of disease progression or death (PFS HR 1.84).
- Subgroup analyses confirmed that the prognostic value of CRP remained consistent across different patient groups.
The researchers also performed sensitivity and publication bias analyses, both of which confirmed the reliability of the findings. However, they acknowledged a few limitations. The studies varied in terms of CRP thresholds, and there was notable heterogeneity among the included papers. Furthermore, the analysis of PFS was based on a relatively smaller sample—only five studies involving 1,252 patients, which calls for caution in interpreting these results.
Despite these limitations, the study marks the first meta-analysis to specifically focus on CRP’s role in melanoma prognosis. The consistent association between high CRP levels and poor outcomes suggests that CRP could be a useful biomarker in clinical settings, helping physicians better stratify risk and personalize treatment approaches for melanoma patients.
The authors concluded, "The meta-analysis supports the role of CRP as a promising prognostic marker in melanoma, offering clinicians an accessible and cost-effective tool to guide patient care decisions. Further large-scale studies with standardized CRP cut-off values are recommended to validate these findings."
Reference:
Xing, X., & Fang, Z. (2025). Prognostic value of C-reactive protein in patients with melanoma: a meta-analysis. Annals of Medicine, 57(1). https://doi.org/10.1080/07853890.2025.2521446
