Colorectal cancer—a multivariate analysis of prognostic factors

Wolters, U; Stützer, H.; Keller, Harald; Schröder, U.; Pichlmaier, H.

doi:10.1016/s0748-7983(96)92320-3

Cited by 35 publications

(28 citation statements)

References 30 publications

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“…Overall survival decreased in patients older than 70 years in this study; other groups reported similar results (11,13,14). The significance of age has been frequently reviewed and yet remains controversial.…”

Section: Discussionsupporting

confidence: 77%

“…Previous studies have analysed clinicopathological variables such as age (over 70 years), gender, size, vascular invasion and tumour stage (11,12) However, in this study we have also added plasma big ET-1 levels as a clinical variable available prior to surgery. A plasma level of >4.2 pg/mL was chosen, as this was the upper limit of big ET-1 levels in age-and sex-matched controls (Fig.…”

Section: Data Collectionmentioning

confidence: 99%

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Prognostic Significance of Elevated Endothelin-1 Levels in Patients with Colorectal Cancer

2004

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Background: Prognostic factors from clinical, laboratory and pathological data of patients with colorectal cancer are essential to identify high-risk groups to whom beneficial adjuvant therapy could be given. Endothelin-1, a growth factor, has been associated with the development and spread of solid tumours. This prospective study was performed to determine whether preoperative plasma big ET-1 levels might be useful as a prognostic indicator in patients with colorectal carcinoma. Method: Sixty-five consecutive patients with colorectal cancer confirmed by biopsy were included prospectively into this study over a 12-month period. Plasma samples from a peripheral vein were obtained prior to surgery. Univariate analysis of survival using age (< or > 70 years), sex, Dukes' stage (A&B versus C), tumour size (< or > 50 mm), vascular invasion and plasma big ET-1 levels was performed and significant factors were then analysed with the Cox regression model.

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Section: Discussionsupporting

confidence: 77%

Section: Data Collectionmentioning

confidence: 99%

Prognostic Significance of Elevated Endothelin-1 Levels in Patients with Colorectal Cancer

2004

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“…Thus, different age ranges of the populations studied, or different age groups chosen for the analyses, together with a variable prevalence of nonneoplastic diseases in the evaluated series, can explain the discordant results in the scientific literature regarding age and colorectal cancer. Indeed, different authors have found an independent unfavourable effect of increasing age (Korenaga et al, 1991;Gasser et al, 1992;Crocetti et al, 1996;D'Eredita et al, 1996;Wolters et al, 1996;Payne and Meyer, 1997;Tominaga et al, 1997;Heys et al, 1998;Lagautriere et al, 1998;Fietkau et al, 2004;Munemoto et al, 2004), of the youngest and oldest age ranges, indifferently (Chung et al, 1998;Cerottini et al, 1999;Massacesi et al, 2002) or even of young age (Cai et al, 2005), while other investigators were not able to demonstrate any prognostic effect at all (Ponz de Leon et al, 1992;Wang et al, 2000;Mitry et al, 2004;Latkauskas et al, 2005). Only JanssenHeijnen et al (2005) evaluated relative survival of patients with several cancers, utilising data from the Southern Netherlands Cancer Registry.…”

Section: Discussionmentioning

confidence: 99%

New insights into the role of age and carcinoembryonic antigen in the prognosis of colorectal cancer

et al. 2007

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The aim of this study was to verify through relative survival (an estimate of cancer-specific survival) the true prognostic factors of colorectal cancer. The study involved 506 patients who underwent locally radical resection. All the clinical, histological and laboratory parameters were prognostically analysed for both overall and relative survival. This latter was calculated from the expected survival of the general population with identical age, sex and calendar years of observation. Univariate and multivariate analyses were applied to the proportional hazards model. Liver metastases, age, lymph node involvement and depth of bowel wall involvement were independent prognosticators of both overall and relative survival, whereas carcinoembryonic antigen (CEA) was predictive only of relative survival. Increasing age was unfavourably related to overall survival, but mildly protective with regard to relative survival. Three out of the five prognostic factors identified are the cornerstones of the current staging systems, and were confirmed as adequate by the analysis of relative survival. The results regarding age explain the conflicting findings so far obtained from studies considering overall survival only and advise against the adoption of absolute age limits in therapeutic protocols. Moreover, the prechemotherapy CEA level showed a high clinical value. British Journal of Cancer (2008) A large body of investigational data demonstrates that the prognosis of patients undergoing bowel resection for colorectal cancer is mainly determined by factors related to local tumour growth and the presence or absence of nodal and/or distant metastases. Many classification systems have been devised to categorise these anatomical factors for clinical use but an increasing number of new pathological and nonanatomical elements show interesting correlations with survival and would be worth testing systematically for selective integration into the available staging classifications. Improvement of the prognostic accuracy of these classifications might allow a more flexible use of the increasing number of new drugs and therapeutic options now available for postsurgical management of patients with colorectal cancer. However, since this malignancy is a disease of the elderly and the populations of developed countries are ageing rapidly, overall survival, as currently investigated, may not be the most suitable outcome parameter for evaluating the real prognostic impact of tumour-linked factors. Because about one-half of all colorectal carcinomas in our series occur in people aged 65 years or older, and a considerable number of these subjects die of other causes with no evidence of cancer, a fraction of these deaths should not be related to the tumour.There are two main purposes of the present work: (1) to verify the prognostic significance of the current clinicopathological factors through a study of both overall and relative survival, this latter being a selective estimate of the chance of surviving the effects of cancer; (2) to includ...

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“…CRC is staged according to the extent of primary organ involvement and metastatic spread to lymph nodes or distant organs (4)(5)(6)(7). Stage II (no lymph node or distant metastases) cancer patients have a 5-year survival of 75% to 80% when surgically treated.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and Prognostic MicroRNAs in Stage II Colon Cancer

et al. 2008

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MicroRNAs (miRNA) are a class of small noncoding RNAs with important posttranscriptional regulatory functions. Recent data suggest that miRNAs are aberrantly expressed in many human cancers and that they may play significant roles in carcinogenesis. Here, we used microarrays to profile the expression of 315 human miRNAs in 10 normal mucosa samples and 49 stage II colon cancers differing with regard to microsatellite status and recurrence of disease. Several miRNAs were differentially expressed between normal tissue and tumor microsatellite subtypes, with miR-145 showing the lowest expression in cancer relative to normal tissue. Microsatellite status for the majority of cancers could be correctly predicted based on miRNA expression profiles. Furthermore, a biomarker based on miRNA expression profiles could predict recurrence of disease with an overall performance accuracy of 81%, indicating a potential role of miRNAs in determining tumor aggressiveness. The expression levels of miR-320 and miR-498, both included in the predictive biomarker, correlated with the probability of recurrence-free survival by multivariate analysis. We successfully verified the expression of selected miRNAs using real-time reverse transcription-PCR assays for mature miRNAs, whereas in situ hybridization was used to detect the accumulation of miR-145 and miR-320 in normal epithelial cells and adenocarcinoma cells. Functional studies showed that miR-145 potently suppressed growth of three different colon carcinoma cell lines. In conclusion, our results suggest that perturbed expression of numerous miRNAs in colon cancer may have a functional effect on tumor cell behavior, and, furthermore, that some miRNAs with prognostic potential could be of clinical importance. [Cancer Res 2008;68(15):6416-24]

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Colorectal cancer—a multivariate analysis of prognostic factors

Cited by 35 publications

References 30 publications

Prognostic Significance of Elevated Endothelin-1 Levels in Patients with Colorectal Cancer

Prognostic Significance of Elevated Endothelin-1 Levels in Patients with Colorectal Cancer

New insights into the role of age and carcinoembryonic antigen in the prognosis of colorectal cancer

Diagnostic and Prognostic MicroRNAs in Stage II Colon Cancer

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