Resection of colorectal cancer (CRC) metastases in routine practice.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 599-599
Author(s):  
Ben Tran ◽  
Hui-li Wong ◽  
Kathryn Maree Field ◽  
Jeanne Tie ◽  
Jeremy David Shapiro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Performance Status ◽  
Distant Metastases ◽  
Public Hospitals ◽  
Routine Practice ◽  
Disease Site ◽  
Multimodality Approach ◽  
Treatment Intent ◽  
Critical Intervention

599 Background: The optimal management of metastatic colorectal cancer (mCRC) involves a multimodality approach. Complete resection of limited metastatic disease is a critical, potentially curative intervention for a minority of patients (pts). Data on resection rates and outcomes in routine clinical practice are limited. Methods: Analysis of pts prospectively entered onto the TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) database, a multisite Australian mCRC registry. Data collection commenced in July 2009 and is ongoing at 14 centres. Treatment intent was recorded at initial pt review as curative, potentially curative or palliative. Results: At median follow-up of 20.9 months, 213 (21%) of 1,012 pts have undergone metastasectomy, including 179 (84%) R0 resections. Liver (55.4%) and lung (20.2%) were the commonest resected disease sites. For 26 (12.2%) pts the initial treatment intent had been palliative. Pts who had metastases resected were younger (median age 63 vs. 70 years, p<0.0001), of better performance status (PS0-1: 97.7 vs. 75.5%, p<0.0001), had fewer comorbidities (Charlson Index ≤3: 75.1 vs. 55.9%, p<0.0001) and fewer sites of disease (single site: 79.8% vs. 52.5%, p<0.0001). A significantly higher proportion of pts treated in private than public hospitals underwent resections: 143/548 (26.1%) vs. 70/459 (15.3%), p<0.0001. At initial presentation, more private pts had PS0-1 (82.8% vs. 77.8%, p=0.0459) and single disease site (61.3% vs. 54.5%, p=0.0291) than public pts, but the median age of private pts was higher (70 vs. 67 years, p=0.041). Overall survival was equivalent for resected pts in both groups (median not reached, HR 0.96, 95% CI 0.45-2.06, p=0.9189). Conclusions: A substantial proportion of mCRC pts in routine practice undergo resection of distant metastases, including some pts initially considered incurable. Significant variation between sites has been noted, which may relate to differences in pt population and/or a more aggressive treatment approach. Multivariate analyses and review of individual centre data are planned to explore reasons for potential underutilization of this critical intervention.

Colorectal cancer nutritional and quality-of-life parameters predict patients outcomes after radiotherapy: Long-term follow-up from a prospective randomized controlled trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14570-14570
Author(s):  
P. Ravasco ◽  
I. Monteiro Grillo ◽  
M. Camilo
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Controlled Trial ◽  
Distant Metastases ◽  
Disease Outcome ◽  
Nutritional Counseling ◽  
Diet Intake

14570 Background: Long term data of our published randomized trial of nutritional therapy in colorectal cancer showed that nutritional counseling optimizes pts prognosis. This study aimed to search whether outcomes were affected by individual nutritional & Quality of Life (QoL) parameters after nutrition intervention and radiotherapy (RT). Methods: Data were obtained from the trial pts’ records: G1 (n=37) on individualized nutritional counseling & education (regular foods), G2 (n=37) ad lib+polymeric protein supplements & G3 (n=37) ad lib intake. After RT, current intake (diet history), nutritional status (PG-SGA) & QoL scores (EORTC) were evaluated; their ability to predict survival, disease outcome [loco regional recurrence (LRR), distant metastases] & late RT toxicity (permanent flatulence, abdominal distension, diarrhea) were analyzed after a median follow-up of 3.7 (2.0–5.8) yrs. Results: Energy/protein intakes had decreased in G3 (p<0.01) & increased in G1>G2, p=0.007; wasting only occurred in G3>G2 (p<0.05); QoL scores worsened in G3>G2 (p<0.05) yet improved in G1, p<0.01. On multivariate analyzis of coded time-dependent variables: poorer diet intake, nutritional wasting & worse QoL scores were associated with decreased survival (p<0.002), LRR (p=0.01), distant metastases (p=0.005) & late RT toxicity, p<0.003. Landmark analysis showed that pts with nutritional intake/status & QoL deterioration, had significantly lower survival (hazard ratio [HR]: 8.25; 95% CI 2.74–26.47; p<0.001), worse disease outcome (HR: 8.15; 95% CI 2.22–25.40; p<0.002) & more severe late RT toxicity (HR: 7.15; 95% CI 2.25–16.11; p<0.004). Conclusions: In colorectal cancer after RT, poor diet intake, wasting & deteriorated QoL look as if significant predictors of survival, treatment response & late RT toxicity; such patients are prone to a more aggressive clinical course. No significant financial relationships to disclose.

Is there a role for chemotherapy in metastatic colorectal cancer patients with a poor performance status?

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 534-534
Author(s):  
Hui-li Wong ◽  
Kathryn M Field ◽  
Jeanne Tie ◽  
Suzanne Kosmider ◽  
Jeremy David Shapiro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Clinical Care ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Routine Practice ◽  
Ecog Ps ◽  
To Receive

534 Background: The management of patients with poor performance status (PS) remains challenging in the absence of data on optimal treatment. Here we assessed the treatment and outcomes of patients with metastatic colorectal cancer (mCRC) with poor Eastern Cooperative Oncology Group (ECOG) PS (≥ 2) in routine clinical care. Methods: Analysis of patients prospectively entered onto the TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) database, a clinician-designed initiative to collect comprehensive data on consecutive patients with mCRC from sites across Australia. Data collection commenced in July 2009 and is ongoing at 14 participating public and private centres. Results: Of the 679 patients entered, 129 (19.0%) had an ECOG PS ≥ 2. In total, 77 (11.3%) were PS 2, 41 (6.0%) PS 3 and 11 (1.6%) PS 4. Chemotherapy was administered to 55 (71.4%) PS 2 and 15 (36.6%) PS 3 patients, with none of the PS 4 patients being treated. Overall, poor PS patients were significantly less likely to receive any chemotherapy compared to their good PS (PS 0-1) counterparts (55.0% versus 86.8%, p<0.0001) and, when chemotherapy was given, significantly less likely to receive combination chemotherapy (38.0% vs 71.6%, p<0.0001) or bevacizumab (15.5% vs 46.9%, p<0.0001). Overall survival (OS) was reduced with declining PS, with medians of 31.2, 9.0, 3.0 and 0.8 months for PS 0-1, 2, 3 and 4 patients respectively (p<0.0001). Poor PS patients treated with chemotherapy had a better OS outcome (9.8 vs 4.1 months for untreated patients, p<0.0001). At one and two years, 22 (31.4%) and 8 (11.4%) treated poor PS patients were alive. Conclusions: In routine practice many patients with a poor PS, particularly those that are PS 2, receive active treatment. Although overall survival for poor PS patients is poor, some patients appear to benefit from treatment. Further data analysis, particularly to define subsets that may benefit most from treatment, is planned as further sites around Australia contribute data to the project.

scholarly journals Evaluation of outcomes in elderly patients diagnosed with colorectal cancer

2018 ◽  
Vol 5 (4) ◽  
pp. 1201
Author(s):  
Neil Lawrence ◽  
Joshua Griffiths ◽  
Keith Chapple
Keyword(s):  
Colorectal Cancer ◽  
Operative Treatment ◽  
Emergency Surgery ◽  
Performance Status ◽  
Significant Risk ◽  
Distant Metastases ◽  
The Elderly ◽  
High Morbidity ◽  
Tertiary Referral Centre ◽  
Emergency Presentation

Background: Colorectal cancer in the elderly carries a high morbidity and mortality. The National Bowel Cancer Audit Programme is a high-quality audit incorporating all UK colorectal cancer patients. Author analysed this database to investigate the local outcomes for this high-risk group.Methods: Data (mode of presentation, presence of metastatic disease, treatment surgery, colonic stent or conservative and WHO performance status) was collected on all patients aged 85 years or over diagnosed with colorectal cancer at a large tertiary referral centre over a 5-year period. Ninety day and 2 year-mortality was obtained for all patients.Results: Ninety patients (45 male, 45 female, median age 88.9 range 85.0-97.9 years) were included (47 emergency presentation, 43 elective presentation). A 18 of 47 patients underwent emergency surgery. A 90-day and 2-year mortality in this group was 17% and 69% respectively. 29 of 47 patients presenting as an emergency had non-operative treatment (2-year mortality 87%). Two years mortality for patients undergoing emergency surgery was 100% if aged above 90 years or if distant metastases were present. Eleven of 43 patients presenting electively underwent surgery. 90-day and 2-year mortality for this group was 18% and 0% respectively. Two years mortality for those presenting electively and undergoing non-operative treatment was 62%.Conclusions: Decision making must be very carefully considered in patients aged over 85 years as the presence of metastases, poor WHO performance status or age over 90 carries with it a significant risk of mortality at both 90 days and 2 years following diagnosis.

scholarly journals P-OGC56 Do patients presenting with obstructing oesophageal cancer have worse outcome?

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Siobhan Chien ◽  
Khurram Khan ◽  
Lewis Gall ◽  
Colin MacKay ◽  
Andrew Macdonald ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Performance Status ◽  
Newly Diagnosed ◽  
Ecog Performance Status ◽  
Curative Intent ◽  
Early Presentation ◽  
Upper Gi ◽  
The United Kingdom ◽  
Treatment Intent

Abstract Background Oesophageal cancer carries a poor prognosis.  Despite the availability of urgent Upper GI endoscopy in the United Kingdom, a substantial proportion of patients with newly diagnosed oesophageal cancer present late with near total dysphagia and an obstructing tumour at the index endoscopy.  There is little data analysing the effect of obstructing oesophageal cancer at presentation on overall prognosis.  The aim of the study was to analyse if patients presenting with obstructing oesophageal cancer have a worse outcome. Methods A retrospective cohort study of all newly diagnosed oesophageal cancers (adenocarcinoma and squamous cell carcinoma) and high grade dysplasia registered in a single UK Regional Upper GI MDT between October 2019 and September 2020 was performed.  Electronic records were interrogated and patients dichotomised into two groups based on if they were obstructed endoscopically or not on the index endoscopy and the results were compared.  Median follow up was 7 months. Results 243 patients (68 (28.0%) obstructed and 175 (72.0%) non-obstructed) with median age of 70 were identified.  There were more females in the obstructed group (44.1% vs 25.7%, p = 0.005).  ECOG performance status was worse in the obstructed group: ECOG-0 (30.9% vs 50.3%, p = 0.006).   Adenocarcinoma was more common in non-obstructed group (69.1% vs 54.4%, p = 0.031).  More patients in the obstructed group had a T4 tumour (38.2% vs 18.9%, p = 0.002), however, nodal and metastatic status were similar.  Rates of curative intent treatment were similar.  At median follow-up of 7 months (IQR 3-13), more patients in obstructed group were deceased (72.1% vs 49.7%, p = 0.002). Conclusions Obstructing oesophageal cancer at presentation is a marker of advanced disease and despite curative treatment intent, overall survival is worse compared to passable tumours. New screening techniques such as Cytosponge combined with public health interventions to encourage early presentation may enable earlier diagnosis and improved survival.

FOLFOX as adjuvant chemotherapy after curative resection of distant metastatic lesions in patients with colorectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14142-e14142
Author(s):  
Joji Kitayama ◽  
Hiroaki Nozawa ◽  
Toshiaki Watanabe ◽  
Eiji Sunami
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Antibody Therapy ◽  
Stage Iv ◽  
Distant Metastases ◽  
Prophylactic Effect ◽  
Chemotherapeutic Regimen ◽  
Synchronous Metastases ◽  
Metachronous Metastases

e14142 Background: Although FOLFOX regimen is shown to be effective to suppress the recurrence of stage III colorectal cancer (CRC) who received curative resection, the prophylactic effect of has not fully been investigated in adjuvant setting of stage IV CRC cases, namely, after curative resection of distant metastases. Methods: This is a retrospective study including 116 CRC patients with synchronous metastases and 91 with metachronous metastases who received curative resection in our hospital between 2000 and 2009. Pathological parameters of primary CRC, postoperative chemotherapeutic regimen, relapse-free survival (RFS) were analyzed retrospectively. Results: After resection of CRC and synchronous metastases, 53 (84%) out of 63 patients without chemotherapy, and 38 (83%) out of 46 that received oral or intravenous 5-fluorouracil (5-FU) alone or with leucovorin (LV) developed recurrent tumors. By contrast, only single patient (17%) among 6 who underwent FOLFOX showed recurrence. With a median follow-up period of 775 days, the FOLFOX group exhibited a significantly improved RFS as compared to the 5-FU(+LV) or surgery alone group (p=0.03, p=0.007, respectively). The 5-year OS rates of the surgery alone, 5-FU(+LV), and FOLFOX group were 67%, 75%, and 100%. In CRC cases with metachronous metastases, on the other hand, the recurrence rate of the group without chemotherapy was 63%, and that of the 5-FU (+LV) group 55%. In 7 patients who underwent FOLFOX chemotherapy (5 cases of FOLFOX4 and 2 cases of mFOLFOX6, no antibody therapy) after metastasectomy, 71% (5 patients) relapsed afterward. Thus, the tumor-relapse rate after metastasectomy was similar among patients who received no postoperative chemotherapy. The median RFSs of the surgery alone, 5-FU(+LV), and FOLFOX groups were 323, 917, and 322 days, respectively. Conclusions: Adjuvant FOLFOX is certainly beneficial for stage IV CRC patients with synchronous metastasis who received curative resection. In contrast, the prophylactic effect of FOLFOX is not superior to other follow-up strategies in patients who received complete resection of metachronous metastases.

Is there a role for chemotherapy in metastatic colorectal cancer patients with a poor performance status?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14583-e14583
Author(s):  
Hui-li Wong ◽  
Kathryn M Field ◽  
Jeanne Tie ◽  
Suzanne Kosmider ◽  
Jeremy David Shapiro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Clinical Care ◽  
Performance Status ◽  
Poor Performance ◽  
Poor Performance Status ◽  
Routine Practice ◽  
Ecog Ps ◽  
To Receive

e14583 Background: The management of patients with poor performance status (PS) remains challenging in the absence of data on optimal treatment. Here we assessed the treatment and outcomes of patients with metastatic colorectal cancer (mCRC) with poor Eastern Cooperative Oncology Group (ECOG) PS (≥ 2) in routine clinical care. Methods: Analysis of patients prospectively entered onto the TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) database, a clinician-designed initiative to collect comprehensive data on consecutive patients with mCRC from sites across Australia. Data collection commenced in July 2009 and is ongoing at 14 participating public and private centers. Results: Of the 864 patients entered, 161 (18.6%) had an ECOG PS ≥ 2. In total, 95 (11.0%) were PS 2, 54 (6.3%) PS 3 and 12 (1.4%) PS 4. Chemotherapy was administered to 65 (68.4%) PS 2 and 17 (31.5%) PS 3 patients, with none of the PS 4 patients being treated. Overall, poor PS patients were significantly less likely to receive any chemotherapy compared to their good PS (PS 0-1) counterparts (51.6% versus 86.8%, p<0.0001) and, when chemotherapy was given, significantly less likely to receive combination chemotherapy (67.5% vs 81.1%, p=0.0057) or bevacizumab (31.3% vs 55.8%, p<0.0001). Overall survival (OS) was reduced with declining PS, with medians of 28.7, 8.9, 3.5 and 0.8 months for PS 0-1, 2, 3 and 4 patients respectively (p<0.0001). Poor PS patients treated with chemotherapy had a better OS outcome (9.0 vs 3.5 months for untreated patients, p<0.0001). At one and two years, 24 (28.9%) and 7 (8.4%) treated poor PS patients were alive. Conclusions: In routine practice many patients with a poor PS, particularly those that are PS 2, receive active treatment. Although overall survival for poor PS patients is poor, some patients appear to benefit from treatment. Further data analysis, particularly to define subsets that may benefit most from treatment, is planned as further sites around Australia contribute data to the project.

Monoclonal antibody therapy for resected Dukes' C colorectal cancer: seven-year outcome of a multicenter randomized trial.

1998 ◽  
Vol 16 (5) ◽  
pp. 1788-1794 ◽  
Author(s):  
G Riethmüller ◽  
E Holz ◽  
G Schlimok ◽  
W Schmiegel ◽  
R Raab ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Proportional Hazard ◽  
Antibody Treatment ◽  
Wide Range ◽  
Disease Free ◽  
Dukes C

PURPOSE As previously shown, antibody treatment increased survival of patients with resected colorectal cancer of stage Dukes' C. Since the 5-year analysis was criticized because of the wide range (2.7 to 7.5 years) of follow-up time, we performed a 7-year analysis with only four of 189 patients monitored for less than 5 years. PATIENTS AND METHODS A total of 189 patients with resected Dukes' C colorectal cancer were randomly allocated to infusions of a total of 900 mg 17-1A antibody, 500 mg postoperatively followed by 4 monthly doses of 100 mg (n=99), or to observation only (n=90). Primary end points were overall survival and disease-free interval. Patients were stratified by a dynamic randomization according to center, sex, location of tumor, number of affected lymph nodes, and preoperative carcinoembryonic antigen concentration. RESULTS Randomization produced balanced distribution of risk factors. After 7 years of follow-up evaluation, treatment had reduced overall mortality by 32% (Cox's proportional hazard, P < .01; log-rank, P=.01) and decreased the recurrence rate by 23% (Cox's proportional hazard, P < .04; log-rank, P=.07). The intention-to-treat analysis gave a significant effect for overall survival (Cox's proportional hazard, P < .01; log-rank, P=.02) and disease-free survival (Cox's proportional hazard, P=.02; log-rank, P=.11 ). While distant metastases were significantly reduced (Cox's proportional hazard, P=.004; log-rank, P=.004), local relapses were not (Cox's proportional hazard, P=.65; log-rank, P=.52). This differential effect of 17-1A antibody on disseminated isolated tumor cells versus occult local satellites may explain the increased significance seen in the overall survival. CONCLUSION The now-matured study shows that 17-1A antibody administered after surgery prevents the development of distant metastasis in approximately one third of patients. The therapeutic effect is maintained after 7 years of follow-up evaluation.

scholarly journals 1st-Line Treatment with R-CHOP-14 or R-CHOP-21 in Patients with High-Grade Non-Hodgkin’s Lymphoma Is Similarly Effective: Data from the German Prospective TLN Registry

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4406-4406
Author(s):  
Wolfgang Knauf ◽  
Wolfgang Abenhardt ◽  
Johannes Mohm ◽  
Jacqueline Rauh ◽  
Renate Grugel ◽  
...  
Keyword(s):  
Survival Rate ◽  
Performance Status ◽  
Routine Practice ◽  
Weekly Schedule ◽  
High Grade ◽  
Line Treatment ◽  
Tumour Stage ◽  
Line Therapy ◽  
Dose Dense

Abstract Introduction Combination immunochemotherapy with cyclophosphamide, doxorubicine, vincristine, prednisone and the anti-CD20 monoclonal antibody rituximab (R-CHOP) is the standard of care for patients (pts) with previously untreated high-grade (aggressive) non-Hodgkin’s lymphoma (aNHL). Dose intensification of CHOP has shown ambiguous results (Pfreundschuh, 2004; Ohmachi, 2011), but the dose-dense two-weekly schedule (R-CHOP-14) was not found to be superior to the three-weekly schedule (R-CHOP-21) (Cunningham, 2013). Since clinical trials are restricted to highly selected pts, we investigated effectiveness of R-CHOP-14 and R-CHOP-21 in unselected pts with aNHL treated in routine practice by German office-based haematologists. Methods The open, longitudinal, multicentre, clinical registry on lymphoid neoplasms (TLN Registry, ClinicalTrial.gov registry NCT00889798) prospectively collects data on the treatment of pts with lymphoid B-cell neoplasms as administered by a network of over 260 German office-based haematologists. The choice of therapy is upon the discretion of the treating physician. All pts give their informed consent before onset of therapy. Pts are followed for 5 years. A broad set of data regarding patient and tumour characteristics, co-morbidities, all systemic treatments and response rates, date(s) of progression(s) and date of death are recorded. Automated plausibility and completeness checks with subsequently generated queries by the electronic data capture system ensure data reliability. In addition, data managers regularly check for plausibility and issue queries. Between May 2009 and August 2013 (date of present analysis), a total of 3,383 pts have been recruited. Results Of 477 pts with aNHL (95% DLBCL), recruited at the start of 1st-line therapy and treated with R-CHOP, 43% were treated with the two-weekly schedule (R-CHOP-14) and 57% received the three-weekly schedule (R-CHOP-21). Both schedules were applied for median 6 cycles (range 2-8); less than 6 cycles were applied in 23% and 30% of pts, respectively. Pts were median 67 years (yrs) old (33% ≤ 60 yrs), 47% female, 28% presented with tumour stage I (Ann Arbor), 27% with stage IV and 64% with at least one co-morbidity. 37% pts were of low risk (International Prognostic Index, IPI). Pts treated with the R-CHOP-14 or R-CHOP-21 differed in gender (female: 42% vs. 50%), performance status (ECOG 0: 44% vs. 40%) and pre-existing co-morbidities (60% vs. 67%), with no difference in age. Pts treated with R-CHOP-14 were diagnosed less often with tumour stage I (22% vs. 33%). Data on the application of Granulocyte colony-stimulating factor (G-CSF) were available for 381 pts. G-CSF was applied in 98% of pts treated with R-CHOP-14 and 61% of pts treated with R-CHOP-21. Pts treated with R-CHOP-21 and G-CSF were older (median 68 vs. 61yrs) than pts treated with R-CHOP-21 and no application of G-CSF. Objective response rate (ORR) as assessed by the local site was: 98% for R-CHOP-14 and 94% for R-CHOP-21; the clinical (unconfirmed) complete remission rate (CRu) was 65% for R- CHOP-14 and 70% for R-CHOP-21 (p=0.32). After a median follow-up of 22 months (maximum 51 months), 2-year progression-free survival rate (PFS) is 74% (1-year: 84%) for R-CHOP-14 and 82% (1-year: 85%) for R-CHOP-21. 2-year overall survival rate (OS) is 86% (1-year: 91%) for R-CHOP-14 and 85% (1-year: 89%) for R-CHOP-21. At time of analysis, 9% of pts (R-CHOP-14) and 8% (R-CHOP-21) have received a 2nd-line therapy. Overall, 7% of pts have been lost to follow-up. At this point, the high rate of pts alive without progression (>80%) precluded multivariate regression analyses regarding factors affecting PFS or OS. Conclusion Our data show that in routine practice, independent of age, pts with good performance status and low burden of co-morbities are more likely to receive the dose-dense two-weekly R-CHOP-14 schedule than the three-weekly R-CHOP-21 schedule as 1st-line treatment. First outcome data show that the effectiveness (ORR, PFS and OS) of both schedules is similar despite the differences in pts selection. DLBCL: Diffuse Large B-cell Lymphoma References: Cunningham et al., The Lancet. Mai 2013;381(9880):1817–26 │ Ohmachi K et al., Ann Oncol. 2011;22(6):1382–91 │ Pfreundschuh M et al., Blood. 2004;104(3):634–41 Disclosures No relevant conflicts of interest to declare.

scholarly journals Serum Matrix Metalloproteinase-2, -7 and -9 (MMP-2, MMP-7, MMP-9) levels as Prognostic Markers in Patients with Colorectal Cancer

2012 ◽  
Vol 2 (3) ◽  
pp. 169-175
Author(s):  
Elena Kostova ◽  
Maja Slaninka Miceska ◽  
Nikola Labacevski ◽  
Krume Jakjovski ◽  
Jasmina Trojacanec ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Markers ◽  
Tumour Progression ◽  
Distant Metastases ◽  
Serum Levels ◽  
Postoperative Treatment ◽  
Matrix Metalloproteinase 2 ◽  
Poor Survival ◽  
Disease Staging

Introduction: Matrix metalloproteinases are produced by tumour cells, hence, they may be associated with tumour progression including invasion, migration, angiogenesis and metastasis. Finding prognostic markers to better identify patients with higher risk for poor survival would be valuable in order to customize pre- and postoperative treatment as well as to enable closer follow-up of these patients. Aim of our study was to examineMMP-2, MMP-7 and MMP-9 serum levels and correlated them with pathological data such as stage of the colorectal cancer (CRC) and outcome.Methods: The investigation included 82 patients with operable CRC without distant metastases, who had underwent blood tests in order to determine the MMP-2, MMP-7 and MMP-9 serum levels in the following time periods: preoperatively, 3, 6, 9 and 12 months postoperatively.Results: The values of the investigated MMPs decrease postoperatively and start to increase 6 month later in patients of all stages of the disease, reaching the highest value 12 month postoperatively with statistically important differences of MMP-2, MMP-7 and MMP-7 serum levels in terms of disease staging and defined points of time. Analysis of the results showed that the MMP-2 serum levels obtained 3 and 12 months postoperatively,than MMP-7 serum levels 12 months postoperatively and the MMP-9 serum levels in all analyzed points in time were in significant association with the CRC patients’outcome.Conclusion: The MMP-2, MMP-7 and especially MMP-9 serum values could be important indicators for diagnosis of the patients with CRC and for monitoring of disease progression.

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