scholarly journals Preoperative C-reactive Protein as a Prognostic Factor in Stage IV Colorectal Cancer

2020 ◽  
Author(s):  
Hiroka Kondo ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Shintaro Ishikawa ◽  
Takatsugu Fujii ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Survival Rate ◽  
Stage Iv ◽  
R0 Resection ◽  
C Reactive Protein ◽  
Factors Affecting ◽  
Reactive Protein ◽  
Stage Iv Colorectal Cancer

Abstract Background: A prognosis for stage IV colorectal cancer is generally poor. As a result, the development of an appropriate treatment strategy for each individual with this disease within a limited time frame is important. In various malignancies, preoperative high C-reactive protein (CRP) levels may be a possible poor prognostic factor. However, few studies have been made of CRP in stage IV cases of colorectal cancer so it is unclear whether CRP is a useful prognostic marker for this disease. Thus, the purpose of this study was to clarify the relationship between the preoperative CRP level and the prognosis of stage IV colorectal cancer.Patients and methods: Between April 2007 and December 2015, 384 patients with stage IV colorectal cancer who underwent primary resection were included. Patients were divided into high (HCG) and low (LCG) CRP groups based on a preoperative CRP cut-off value of ³1.0 mg/dL. Postoperative short- and long-term results were examined retrospectively.Results: Preoperative carcinoembryonic antigen (CEA) levels were higher in HCG; the number of R0 surgical resections of distant metastases was smaller. The 5-year survival rate was 24.6% for HCG and 36.7% for LCG, indicating the survival rate for HCG was lower. A multivariate analysis of factors affecting survival rates identified CRP >1.0, histopathological type, positive venous infiltration, and R0 inoperability as risk factors. The rate of R0 resection was higher in LCG. Concerning R0 resection patients, differences between HCG and LCG with regard to background factors, including preoperative CEA levels, were not found. In terms of long-term survival, a significant difference in overall survival between the two groups was not observed. The study was limited to patients who were unable to undergo R0 surgery. Preoperative CEA levels were higher in HCG while the postoperative chemotherapy induction rate was lower. HCG also showed a significantly lower survival rate than LCG. Multivariate analysis showed that CRP levels above 1.0 mg/dL, poorly differentiated histopathology, and the absence of chemotherapy were risk factors affecting overall survival.Conclusion: These results suggest that the preoperative CRP level may be a useful biomarker for the prognosis of incurable stage IV colorectal cancer.

scholarly journals Preoperative C-reactive protein as a prognostic factor in stage IV colorectal cancer

2021 ◽  
Author(s):  
Hiroka Kondo ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Shintaro Ishikawa ◽  
Takatsugu Fujii ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Rate ◽  
Stage Iv ◽  
Time Frame ◽  
Long Term Results ◽  
Factors Affecting ◽  
Lower Survival Rate ◽  
Reactive Protein ◽  
Stage Iv Colorectal Cancer ◽  
Colorectal Cancer Patients

Background A prognosis for stage IV colorectal cancer is generally poor. As a result, the development of an appropriate treatment strategy for each individual with this disease within a limited time frame is important. Few studies have been made of CRP in stage IV cases of colorectal cancer so it is unclear whether CRP is a useful prognostic marker for this disease. Thus, the purpose of this study was to clarify the relationship between the preoperative CRP level and the prognosis of stage IV colorectal cancer. Patients and methods Between April 2007 and December 2015, 384 patients with stage IV colorectal cancer who underwent primary resection were included. Patients were divided into high (HCG) and low (LCG) CRP groups based on a preoperative CRP cut-off value of ≥1.0 mg/dL. Postoperative short- and long-term results were examined retrospectively. Results The 5-year survival rate was 24.6% for HCG and 36.7% for LCG, indicating the survival rate for HCG was lower. The study was limited to patients who were unable to undergo R0 surgery. Preoperative CEA levels were higher in HCG while the postoperative chemotherapy induction rate was lower. HCG also showed a significantly lower survival rate than LCG. Multivariate analysis showed that CRP levels above 1.0 mg/dL, poorly differentiated histopathology, and the absence of chemotherapy were risk factors affecting overall survival. Conclusion These results suggest that the preoperative CRP level may be a useful biomarker for the prognosis of incurable stage IV colorectal cancer.

Prognostic significance of the preoperative serum C-reactive protein level in patients with stage IV colorectal cancer

Surgery Today ◽  
2014 ◽  
Vol 45 (3) ◽  
pp. 315-321 ◽  
Author(s):  
Masatsune Shibutani ◽  
Kiyoshi Maeda ◽  
Hisashi Nagahara ◽  
Eiji Noda ◽  
Hiroshi Ohtani ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Protein Level ◽  
Prognostic Significance ◽  
Stage Iv ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Stage Iv Colorectal Cancer ◽  
Preoperative Serum

Prognostic Significance of Peritoneal Metastasis in Stage IV Colorectal Cancer Patients With R0 Resection

2017 ◽  
Vol 60 (10) ◽  
pp. 1041-1049 ◽  
Author(s):  
Keiichi Arakawa ◽  
Kazushige Kawai ◽  
Soichiro Ishihara ◽  
Keisuke Hata ◽  
Hiroaki Nozawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Peritoneal Metastasis ◽  
Prognostic Significance ◽  
Stage Iv ◽  
R0 Resection ◽  
Stage Iv Colorectal Cancer ◽  
Colorectal Cancer Patients

Clinical outcomes of stage IV colorectal cancer after R0 resection: a multi-institutional retrospective analysis

2016 ◽  
Vol 22 (2) ◽  
pp. 297-306 ◽  
Author(s):  
Harunobu Sato ◽  
◽  
Koutarou Maeda ◽  
Zenichi Morise ◽  
Hiroshi Takahashi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Stage Iv ◽  
R0 Resection ◽  
Stage Iv Colorectal Cancer

Post-operative C-reactive protein concentration: A potential therapeutic target following surgery for colorectal cancer?

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 597-597
Author(s):  
David G. Watt ◽  
James Hugh Park ◽  
Stephen Thomas McSorley ◽  
Paul G. Horgan ◽  
Donald C McMillan
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Elective Surgery ◽  
Tnm Stage ◽  
C Reactive Protein ◽  
Potential Therapeutic Target ◽  
Term Survival ◽  
Reactive Protein

597 Background: Post-operative C-reactive protein concentrations (CRP) have been reported to be associated with the development of complications following surgery for colorectal cancer (CRC). The development of complications and an exaggerated post-op CRP are associated with poor long term survival. However, whether this is due to the complication or to the CRP concentration remains unclear. Therefore, the aim of the present study was to determine whether post-op CRP concentrations, independent of post-op complications, were associated with poor long term survival following surgery for CRC. Methods: Included patients were obtained from a prospectively maintained database of CRC resections from a single institution (1999-2013). The relationship between post-op CRP concentrations and overall survival (OS) was examined using Cox regression analysis. Results: 813 patients were included. The majority of patients were > 65 yrs (67%), male (55%) and underwent elective surgery (90%). 257 patients (32%) suffered a complication. Median follow up was 49 months with 314 deaths. In those undergoing elective surgery, 508 patients had an uncomplicated post-op course. In these patients, post-op CRP was significantly lower, on post-op days 2, 3 and 4 (p < 0.001) compared to those with complications. On univariate survival analysis, CRP concentrations on day 2 (HR 1.003, p = 0.008), 3 (HR 1.003, p = 0.024) and 4 (HR 1.003, p = 0.019) were associated with poorer overall survival. On multivariate analysis, adjusting for age, sex and TNM stage, day 2 CRP (HR 1.003, p = 0.006), age (HR 1.70, p < 0.001) and TNM stage (HR 1.61, p < 0.001) were independently associated with poorer survival. On multivariate analysis, adjusting for age, sex and TNM stage, day 3 CRP (HR 1.003, p = 0.030), age (HR 1.70, p < 0.001) and TNM stage (HR 1.63, p < 0.001) were independently associated with poorer survival. Conclusions: In patients undergoing elective surgery for CRC who have an uncomplicated post-op course, the post-op day 2 and 3 CRP concentrations were independently associated with poorer survival. Therefore, CRP could be considered a potential therapeutic target in future attempts to try and improve outcomes following surgery for CRC.

Incidence of and risk factors for hospitalizations from chemotherapy among patients with stage III and stage IV colorectal cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16090-e16090
Author(s):  
April Falconi ◽  
Ezra Fishman ◽  
John Barron ◽  
Michael Eleff ◽  
Michael Jordan Fisch ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Cancer Treatment ◽  
Stage Iv ◽  
Incidence Rates ◽  
Stage Iii ◽  
Treatment Regimens ◽  
Medical Needs ◽  
Stage Iv Colorectal Cancer ◽  
Patients With Diabetes

e16090 Background: Despite the decreasing colorectal cancer (CRC) mortality rate over the past decade, complications from CRC treatment remain a challenge. Prior research has shown that a majority of patients with stage III CRC in the adjuvant setting experience hospitalizations due to chemotherapy-related toxicity. Minimal research, however, has examined risk factors of these events and the prevalence of hospitalization among stage IV CRC patients. Methods: We used claims data from a geographically-diverse private health insurer—including both commercially-insured and Medicare Advantage patients—to estimate and characterize risk factors of hospitalizations among Stage III or IV CRC patients. We compared sociodemographic, clinical, as well as provider characteristics and cancer treatment regimens between patients with and without hospitalizations from the initiation of chemotherapy to 60 days after the end of chemotherapy. Results: Incidence rates for hospitalization from chemotherapy were 49% and 70% for stage III and IV CRC patients, respectively. Although the oldest stage III CRC patients (age 75+) were the most likely to experience hospitalizations, the youngest age group (age 18-49) of stage IV patients experienced the highest incidence (74%) of hospitalizations (p < 0.05). Higher values of the Elixhauser comorbidity index was associated with a higher risk for hospitalizations among patients with stage III CRC (p < 0.001). Both stage III and stage IV patients with diabetes were more likely (p < 0.05) to have hospitalizations from chemotherapy (55% and 73%, respectively). Conclusions: Hospitalization from chemotherapy is very common among stage III and IV CRC patients. These data identify subgroups at higher risk. Study findings may inform choice of cancer treatment regimen and focus on key underlying medical needs

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