High-Grade Inflammation Attenuates Chemosensitivity and Confers to Poor Survival of Surgical Stage III CRC Patients

Ying, Hou-Qun; You, Xia-Hong; Liao, Yu-Cui; Sun, Fan; Cheng, Xue-Xin

doi:10.3389/fonc.2021.580455

Cited by 3 publications

(2 citation statements)

References 44 publications

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“…These findings are concordant with the results of Dienstmann et al who investigated stage II-III CRC patients and showed a significant decrease in survival rates in stage III CRC patients, which was accompanied by lymph node metastasis [ 15 ]. Furthermore, Ying et al, in their study of 1,181 stage I-III CRC patients, showed that persistent high inflammation levels reduce the effectiveness of chemotherapy and play a role in the unfavorable outlook for individuals with stage III surgical CRC [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors Influencing Survival in Stage II and Stage III Colorectal Cancer Patients

Alkader,

Al-Majthoub,

Al-Qerem

et al. 2023

Cureus

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Background Colorectal cancer (CRC) is a global health concern with rising incidence. This study analyzed demographic and clinicopathological factors influencing overall survival (OS) and disease-free survival (DFS) in Jordanian CRC patients. Methodology This retrospective, single-center study collected data from CRC patients at the Royal Medical Services, Jordan, from January 2018 to June 2020. Patient variables included disease stage, stage risk, tumor location, history of chemotherapy, and metastasis status. OS and DFS were defined as the time from surgery to death, last follow-up, or metastasis confirmation. Kaplan-Meier curves and Cox models were used for survival analysis. Results Of 127 CRC patients, 33.3% died during the follow-up period. Most patients were males (55.1%), diagnosed with stage III (55.9%), and classified as high risk (59.2%). Metastasis occurred in 24.4%, and 65.4% received chemotherapy. OS at one, two, and end of the follow-up years was 85.2%, 75.6%, and 66.9%, respectively. Metastasis-free rates were 85%, 78.5%, and 71%, respectively. Multivariate analysis showed that stage III (hazard ratio (HR) = 2.968) and high-risk stage (HR = 2.966) were associated with shorter OS and increased metastasis risk. Right-sided tumors (HR = 2.183) had shorter OS, while chemotherapy recipients (HR = 0.430) had longer OS. Stage III and high-risk stages were strong predictors of mortality, while only stage III and high-risk stages were robust predictors of metastasis. Demographic variables (sex and age) showed no significant associations with survival outcomes. Conclusions Our findings highlight the prognostic significance of disease stage, stage risk, tumor location, and chemotherapy in CRC survival among Jordanian patients. Understanding these factors can guide tailored treatment and improve outcomes.

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors Influencing Survival in Stage II and Stage III Colorectal Cancer Patients

Alkader,

Al-Majthoub,

Al-Qerem

et al. 2023

Cureus

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“…Therefore, FPR can be used as an indicator to differentiate eligible patients for chemotherapy and predict chemotherapy efficacy [35]. A prospective study of 1181 patients undergoing surgery for stage I-III CRC showed that patients with high FPR had a lower survival rate after chemotherapy than patients with low FPR on the same course of treatment, but better than those who did not undergo chemotherapy after surgical resection, and concluded that chronic high-intensity inflammation could reduce the sensitivity of chemotherapy and lead to a poor prognosis for patients with stage III CRC, providing a basis for targeted anti-inflammatory therapy combined with adjuvant chemotherapy, provide new ideas for the clinical application of targeted anti-inflammatory therapy in patients with high FPR [36].…”

Section: Judgement Of Fib On the Efficacy Of Chemotherapymentioning

confidence: 99%

Recent Advances in Fibrinogen Research in Colorectal Cancer

Jiang¹,

Wang²,

Yu³

2023

JBM

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Colorectal Cancer (CRC) is a common malignant tumour of the gastrointestinal tract in China, with increasing morbidity and mortality rates year by year. Most patients are in the middle and late stage when diagnosed, and its high mortality and poor prognosis have seriously threatened the health and life. Fibrinogen (FIB) is mainly used as a coagulation factor in the body to participate in the process of coagulation and haemostasis, and is the main protein in the coagulation process. In recent years, studies at home and abroad have shown that FIB levels correlate with the diagnosis, outcome prediction and prognosis of CRC, and some of the findings are still controversial. This article aims to review the related research and new progress of the relationship between FIB and CRC in recent years.

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Quantification of fibrinogen-to-pre-albumin ratio provides an integrating parameter for differential diagnosis and risk stratification of early-stage colorectal cancer

et al. 2022

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Background Circulating fibrinogen to pre-albumin ratio (FPR) and albumin to fibrinogen ratio (AFR) are effective factors for predicting the prognosis of colorectal cancer (CRC). However, the role of these two ratios in diagnosing early-stage CRC and identifying the stage II CRC subgroup with high relapse risk remains unknown. This study aimed to assess the potential of FPR and AFR in differential diagnosis and risk stratification of early-stage CRC. Methods A discovery (694 and 512 patients with benign colorectal polyps and stage I–II CRC, respectively) and validation (201 benign colorectal polyps cases and 202 stage I–II CRC individuals) cohorts were enrolled in this study. Receiver operating characteristic curve (ROC), Kaplan–Meier curve, and time-dependent ROC were used to evaluate the diagnostic efficacy of AFR and FPR in the two cohorts and overall population, and the discriminating role of FPR in identifying clinical high-relapse risk patients in comparison with common clinical characteristics in stage II CRC patients. Results The area under the curve (AUC) of the preoperative circulating FPR was higher than that of AFR in the diagnosis of stage I–II CRC from colorectal adenomas and benign colorectal polyps in the discovery and validation cohorts and overall population. Carcinoembryonic antigen (CEA) combined with FPR could effectively discriminate early-stage CRC from colorectal adenomas or benign polyps. Preoperative FPR could effectively distinguish stage II subgroups with high and low relapse risk. It was superior to common clinical characteristics in identifying high-risk surgical patients who could benefit from adjuvant chemotherapy (CT) [time-dependent AUC: 0.637 vs. 0.511, p < 0.001 for predicting recurrence-free survival (RFS); 0.719 vs. 0.501, p < 0.001 for predicting overall survival (OS)]. Furthermore, CT treated stage II patients with FPR > 20 had the highest recurrence (31.16%) and death rates (21.88%), with similar highest recurrence (30.70%) and death (26.82%) rates found in non-CT-treated patients with FPR > 20. Stage II CRC patients with 20 ≥ FPR > 15 could significantly benefit from postoperative CT, as the recurrence (33.30%) and death (35.71%) rates within non-CT treated patients were approximately five times higher than those of the CT-treated cases (6.77% and 7.41% for the recurrence and death rates, respectively). No significant difference in recurrence rate was observed between L-FPR (≤ 15) patients with (10.00%) or without CT (9.76%), indicating that these patients might not require to receive adjuvant CT after curative resection. Conclusions Preoperative FPR combined with CEA is superior to common tumor biomarkers, FPR, or AFR in distinguishing early-stage CRC from benign colorectal polyps. Circulating FPR can be an effective biomarker for identifying high-risk patients and choosing suitable therapeutics for early-stage CRC.

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High-Grade Inflammation Attenuates Chemosensitivity and Confers to Poor Survival of Surgical Stage III CRC Patients

Cited by 3 publications

References 44 publications

Prognostic Factors Influencing Survival in Stage II and Stage III Colorectal Cancer Patients

Prognostic Factors Influencing Survival in Stage II and Stage III Colorectal Cancer Patients

Recent Advances in Fibrinogen Research in Colorectal Cancer

Quantification of fibrinogen-to-pre-albumin ratio provides an integrating parameter for differential diagnosis and risk stratification of early-stage colorectal cancer

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