Association Between Serum Creatinine Concentrations and Overall Survival in Patients With Colorectal Cancer: A Multi-Center Cohort Study

Abstract

BackgroundColorectal cancer (CRC) is one of the most common malignancies throughout the world, with high rates of morbidity and mortality. Previous studies reported that serum creatinine (Scr) concentrations were associated with overall survival (OS) in cancer patients, but little is known about the association between Scr and OS in patients with CRC. This study investigated the relationship between Scr concentrations and OS in patients with CRC and examined possible effect modifiers.MethodsA retrospective cohort, including 1,733 patients with CRC, was established from a multi-center clinical study. Patients were divided into low (<71 μmol/L in men or <59 μmol/L in women), normal (71-104 μmol/L in men or 59-85 μmol/L in women) and high (>104 μmol/L in men or >85 μmol/L in women) Scr groups. Cox regression analysis was used to examine association between Scr concentrations and OS. Stratified (subgroup) analyses were used to examine men and women separately. Interaction tests were used to evaluate associations between each variable and OS, as well as possible interactions of these variables with Scr levels. Cross-classified analyses were used only in men.ResultsPatients with low [hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 1.19-1.72; P < 0.001] or high (HR = 1.89, 95% CI = 1.36-2.63; P < 0.001) Scr level had a significantly lower OS than patients with normal Scr levels. Significant interactions with Scr concentrations were observed for body mass index (P for interaction = 0.019) in men.ConclusionLow or high Scr concentration is associated with significantly lower OS in patients with CRC. Future study is warranted to investigate the underlying mechanism.

Serum Creatinine as a Clinical Parameter for Patients with Cancer in End-of-Life: a retrospective cohort study in an acute palliative care unit

“…Previous studies have noted that high Scr is a signi cant prognostic factor in patients with various types and stages of cancer; high preoperative Scr in renal cell carcinoma is associated with impaired 5-year cancer-speci c survival [17]; high Scr in ovarian cancer is related to age at rst diagnosis and predicts poor prognosis [18]; high Scr is an independent predictor of lower overall survival in colorectal cancer patients [19], and independent risk factors in vulvar cancer patients [20]. Therefore, we hypothesized that the survival time of cancer patients in end-of-life can be associated with Scr, which was investigated in this study.…”

“…Serum Cr (Scr) has generally been used as a standard biomarker to evaluate renal function [16]. Several studies have suggested that a high Scr level is associated with poor prognosis in patients with cancer owing to renal dysfunction and cancer progression [17][18][19][20]. Since renal function in patients with terminal cancer declines for various reasons, such as multiple organ failure, dehydration, and nephrotoxicity of cancer treatment, it is assumed that the deterioration of renal function is related to prognosis.…”

Short- (30-90 days) and mid-term (1-3 years) outcomes and prognostic factors of patients with esophageal cancer undergoing surgical treatments

“…Of note, in this study, creatinine levels were independently associated with the prognosis of esophageal cancer, but the P -value was borderline, and it is unknown whether including more patients would tip the balance one way or the other. Creatinine levels have been reported to be independently associated with prognosis in gynecological[ 28 , 29 ] and colorectal[ 30 ] cancers, but no previous studies have reported such an association in esophageal cancer. Further study is required to clarify this issue.…”

Assessment of Serum Urea, Creatinine and Uric Acid in Oral Cancer

“…Similarly, contrasting changes in serum urea levels, the final metabolite of amino acid degradation, were reported in hepatocellular and renal carcinomas in females, suggesting that this parameter may be used as an early detection alternative for these types of malignancies [ 26 , 27 ]. Creatinine, the final product of arginine and glycine degradation, has also been investigated in different types of cancer, sustaining its prognostic character in several types of epithelial cancers [ 28 , 29 , 30 ]. However, in oral cancer, scientific data regarding the assessment of protein metabolism processes and their specific pathways is scarce, sustaining the need for an in-depth investigation to clarify the complex metabolic events associated with oral cancer pathogenesis.…”