scholarly journals Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: Implications for clinical management.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 591-591
Author(s):  
Michela Del Prete ◽  
Riccardo Giampieri ◽  
Fotios Loupakis ◽  
Tiziana Prochilo ◽  
Lisa Salvatore ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Cancer Patients ◽  
Lymphocyte Count ◽  
Progression Free Survival ◽  
Serum Levels ◽  
Clinical Factors ◽  
Roc Curve Analysis ◽  
Related Factors ◽  
Colorectal Cancer Patients

591 Background: Most of the patients receiving regorafenib do not seem to benefit from this treatment approach and are therefore exposed to unnecessary toxicity. Angiogenesis and inflammation-related factors may have a relevant role in modulating the activity of anti-angiogenetic drugs such as regorafenib. In our study, we investigated LDH serum levels, platelet, neutrophil, and lymphocyte counts, and neutrophil-to-lymphocyte ratio (NLR) in predicting clinical outcomes for colorectal cancer patients receiving regorafenib. The final aim was to individuate an easy to use and reliable selection tool for these patients in the clinical practice. Methods: We collected LDH serum levels, neutrophil, lymphocyte, and platelet counts within one month before the start of regorafenib in 208 pretreated metastatic colorectal cancer patients. Cut-off values were calculated by ROC curve analysis. Survival analysis was performed by Kaplan-Meier method, and multivariate analysis by Cox method. Results: At multivariate analysis: high platelet count (p=0.0439), low lymphocyte count (p=0.0013), and high NLR (p=0.0237) were related to worse overall survival (OS); high neutrophil count and high NLR (p=0.0058) were related to worse progression free survival (PFS). Among 52 (25%) patients who were negative for all risk factors, a significant correlation was found with improved OS and PFS if compared with the group of patients with at least one risk factor. In particular, median OS was respectively 15.9 vs. 3.1 months (HR: 3.81, 95% CI: 2.32-4.82, p<0.0001) whereas median PFS was 5.9 vs. 2.1 months (HR: 2.62, 95% CI: 2.06-3.86, p<0.0001). Conclusions: We can speculate that colorectal cancer patients showing high neutrophil, high platelet, low lymphocyte count or high NLR may not be optimal candidates for regorafenib treatment. After confirmation in further prospective series, these clinical factors could play a role in the treatment strategy process.

LDH serum levels as a predictive factor for global outcome in pretreated colorectal cancer patients receiving regorafenib: Implications for clinical management.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 497-497 ◽  
Author(s):  
Michela Del Prete ◽  
Mario Scartozzi ◽  
Tiziana Prochilo ◽  
Luca Faloppi ◽  
Riccardo Giampieri ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Outcome ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Serum Levels ◽  
Roc Curve Analysis ◽  
Group A ◽  
Group B ◽  
Colorectal Cancer Patients

497 Background: Although a demonstrated clinical efficacy, a non negligible proportion of colorectal cancer patients does not seem to benefit from regorafenib and are consequently exposed to unnecessary toxicity. LDH serum levels represent an indirect marker of tumour hypoxia, neo-angiogenesis and worse prognosis in many tumour types. In colorectal cancer LDH showed a correlation with treatment outcome for patients receiving antiangiogenetic treatment, thus suggesting a possible interaction with the activity profile of these drugs. We analyzed the role of LDH serum levels in predicting clinical outcome for pre-treated metastatic colorectal cancer patients receiving regorafenib. The final aim was to individuate a potentially reliable and easy to use marker for patients stratification. Methods: 118 colorectal cancer patients treated with regorafenib were available for our analysis. For all patients, LDH values were collected within one month before the procedure and after treatment end. LDH cutoff value was determined by ROC curve analysis, patients were then divided into two groups (A and B, below and above cut-off level respectively). Patients were also classified according to the variation in LDH serum levels pre- and post-treatment (increased patients vs. decreased patients). Results: Patients in group A and B proved homogeneous for all clinical characteristics analyzed. In group A patients median progression free survival (PFS) was 3.18 months, whereas it was 1.87 months in group B patients (p = 0.0018). Median overall survival (OS) was 6.23 months and 3.28 months in group A and B respectively (p = 0.048). Significant differences were not noted among the 2 groups for response rate. All the other clinical variables analyzed failed to show any correlation with patients outcome. Conclusions: Our observations seem to suggest a role of LDH as a marker of clinical outcome in colorectal cancer patients receiving regorafenib. We can then speculate that high LDH patients may not be optimal candidates for regorafenib. After further confirmation in larger trial, these findings may be relevant for a better patients stratification and selection.

Baseline lymphopenia as a prognostic marker for colorectal carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14107-e14107
Author(s):  
Dilek Erdem ◽  
Idris Yucel ◽  
Bahiddin Yilmaz ◽  
Guzin Demirag ◽  
Yasemin Kemal ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Lymphocyte Count ◽  
Statistical Significance ◽  
Disease Free Survival ◽  
Progression Free Survival ◽  
Hematological Toxicity ◽  
Free Survival ◽  
Increased Risk ◽  
Colorectal Cancer Patients

e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemotherapy-induced toxicity and increased risk of febrile neutropenia, trombocytopenia and anemia in advanced solid neoplasms. This study aims to evaluate the effect of pretreatment lymphopenia on prognosis and hematological toxicity in colorectal cancer patients who received first line systemic chemotherapy. Methods: Lymphocyte count was evaluated in 386 pretreated colorectal cancer patients who do not have a seconder malignancy, HIV infection, bone involvement and primary G-CSF prophylaxis. Overall survival, progression free survival and disease free survival were calculated from date of diagnosis to date of relapse, progression and death. Kaplan-Meier, chi-square and Student-t test were used. Results: Mean follow-up was 30 months (range 1-180 months). Mean age was 57.4±12.5 years. Of all patients, 160 (41 %) were women. Rectum ( 26.2 %) and transvers colon (4.7 %) were the most and the least common anatomic locations, respectively. Mean lymphocyte count before treatment was 1964/µl (170-7000/µl). There were no relationship between lymphopenia and age, sex, performans status, presence of initial metastasis, adjuvant or palliative chemotherapy and hematological toxicity (p>0.05). Grade 3-4 hematological toxicity was found in 40 patients and was significantly higher in patients receiving bi- or tri-chemotherapy regimen (p:0.017). Among 208 patients with relapse or progression, 40 patients had lymphopenia (19.2 %). 1, 3 and 5-year OS were significantly lower in lymphopenic patients (p:0.033). DFS was longer in non-lymphopenic patients but this data didn’t have statistical significance (p>0.05). Conclusions: This study support that lymphocyte number prior to chemotherapy may be a simple but useful prognostic and predictive marker in untreated colorectal cancer patients. Patients with lower pretreatment lymphopenia have lower OS when compared to others (p<0.05). This study has the highest colorectal cancer population in the literature.

472 Addressing the Quality of Hospital Care of Colorectal Cancer Patients Undergoing Surgery: What Did We Learn from the National Bowel Cancer Audit?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C Li ◽  
S Z Y Ooi ◽  
T Woo ◽  
P H M Chan
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
External Validation ◽  
Distant Metastases ◽  
Management Plan ◽  
Bowel Cancer ◽  
Clinical Factors ◽  
Quality Outcomes ◽  
Colorectal Cancer Patients

Abstract Aim To identify the most relevant clinical factors in the National Bowel Cancer Audit (NBOCA) that contribute to the variation in the quality of care provided in different hospitals for colorectal cancer patients undergoing surgery. Method Data from 36,116 patients with colorectal cancer who had undergone surgery were retrospectively collected from the NBOCA and analysed from 145 and 146 hospitals over two years. A validated multiple linear regression was performed to compare the identified clinical factors with various quality outcomes. The quality outcomes defined in this study were the length of hospitalisation, 2-year mortality, readmission rate, 90-day mortality, and 18-month stoma rate. Results Four clinical factors (laparoscopy rate, abdominal-perineal-resection-of-rectum (APER), pre-operative radiotherapy and patients with distant metastases) were shown to have a significant (p &lt; 0.05) impact on the length of hospitalisation and 18-month stoma rate. 18-month stoma rate was also significantly associated with 2-year mortality. External validation of the regression model demonstrated the Root-Mean-Square-Error of 0.811 and 4.62 for 18-month stoma rate and 2-year mortality respectively. Conclusions Hospitals should monitor the four clinical factors for patients with colorectal cancer during perioperative care. Clinicians should consider these factors along with the individual patients’ history when formulating a management plan for patients with colorectal cancer.

scholarly journals Postoperative Serum Levels of sCD26 for Surveillance in Colorectal Cancer Patients

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e107470 ◽  
Author(s):  
Loretta De Chiara ◽  
Ana M. Rodríguez-Piñeiro ◽  
Oscar J. Cordero ◽  
Lidia Vázquez-Tuñas ◽  
Daniel Ayude ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Serum Levels ◽  
Postoperative Serum ◽  
Colorectal Cancer Patients

Bevacizumab Pharmacokinetics Influence Overall and Progression-Free Survival in Metastatic Colorectal Cancer Patients

2016 ◽  
Vol 55 (11) ◽  
pp. 1381-1394 ◽  
Author(s):  
Morgane Caulet ◽  
Thierry Lecomte ◽  
Olivier Bouché ◽  
Jérôme Rollin ◽  
Valérie Gouilleux-Gruart ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Free Survival ◽  
Colorectal Cancer Patients

scholarly journals Composition and Concentration of Serum Fatty Acids of Phospholipids Depend on Tumour Location and Disease Progression in Colorectal Patients

2018 ◽  
Vol 37 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Jolanta Bugajska ◽  
Joanna Berska ◽  
Diana Hodorowicz-Zaniewska ◽  
Krystyna Sztefko
Keyword(s):  
Colorectal Cancer ◽  
Fatty Acids ◽  
Disease Progression ◽  
Cancer Patients ◽  
Distal Colon ◽  
Unsaturation Index ◽  
Serum Levels ◽  
Colorectal Tumour ◽  
Tumour Localization ◽  
Colorectal Cancer Patients

SummaryBackground: Polyunsaturated fatty acids (PUFAs) play a role in the development/progression of colon cancer. The aim of the study was to assess the relation between serum phospholipids PUFAs, colorectal tumour localization and disease progression. Methods: A total of 67 patients (18 with proximal colon, 17 with distal colon and 32 with rectal tumour localization) as well as 16 controls were studied. One year after surgery, 33 patients had disease progression. Serum levels of C16:1(n-7), C18:1(n-9), C18:3(n-3), C20:5(n-3), C22:6(n- 3), C18:2(n-6), C20:2(n-6), C20:4(n-6) fatty acids of se - rum phospholipids were quantitatively measured before surgery by gas-chromatography. Results: Significantly higher mean value of C18:2, as compared to control, has been noted only for patients with proximal (p<0.05) and distal tumour (p<0.03) localization. The lower mean level of C20:5 and unsaturation index (UI) were observed in colorectal cancer patients regardless the tumour localization, but the statistical difference was noted only for patients with proximal tumours (p<0.05, p<0.03). In patients with proximal tumours, significantly lower mean level of C20:4 and UI were noted in patients with disease progression, as compared to patients with proximal tumours without disease progression (p<0.05). Conclusion: The evaluation of PUFAs as a risk/prognostic factor in colorectal cancer patients should take into account tumour localization as a dependent variable.

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