High preoperative serum ferritin predicted poor prognosis in non-metastatic colorectal cancer

Abstract

Objectives:To validate the prognostic significance of preoperative serum iron metabolism parameters in non-metastatic colorectal cancer patients treated with curative resection.Methods:We conducted a prospective cohort study in the Department of Surgical Oncology, WuXi 4th People’s Hospital, WuxiChina, between March 2010 and September 2013. The relationships of serum iron metabolism parameters with other variables were examined. The prognostic significance was evaluated using the Kaplan Meier curve and Cox proportional hazards regression model.Results:Five hundred and fourteen patients were eligible for analysis. The levels of the 3 iron metabolism parameters were interdependent. Hemoglobin level was positively correlated with serum iron and transferrin, and was negatively correlated with ferritin. Compared with peri-neural invasion (PNI)-negative patients, PNI-positive patients had higher serum iron (p=0.03) and ferritin levels (p=0.01). Compared with patients with the lowest quartile level of ferritin, patients with the highest quartile level of ferritin had a 2.21 (95% CI: 1.18-4.14) fold increased mortality risk in the univariate and 2.56 (95% CI: 1.10-5.96) in the multivariate Cox proportional hazards models. When stratified by TNM stages, it was only in stage III patients that serum ferritin remained statistically prognostically significant.Conclusions:Preoperative serum ferritin appeared as an independent adverse risk factor in non-metastatic colorectal cancer.

Meta-analysis of the prognostic value of pretreatment serum ferritin in hepatobiliary and pancreas (HBP) cancers

“… 8 10 14–16 Previous studies have demonstrated that high SF is associated with worse prognosis in lung cancer, colorectal cancer, PC and peripheral T-cell lymphoma. 10 17–19 However, the prognostic role of SF in HCC is controversial. 20 21 …”

Can conventional clinical chemistry tests help doctors in the monitoring of oncology patients?

“…At the same time, there is a higher degree of transferrin serum iron saturation [55,57,58]. Therefore, the determination of the level of latent ironbinding capacity or ferritin concentration is a more accurate indicator of iron deficiency in cancer than the content of iron in the blood serum [58][59][60][61].…”

Inflammatory Markers and MicroRNAs: The Backstage Actors Influencing Prognosis in Colorectal Cancer Patients

“…Hepcidin in turn blocks iron release from macrophages, increases ferritin levels, and lowers transferrin saturation levels [ 30 ]. Ferritin, measured in routine blood examinations, is the primary iron-binding protein that exists both intracellularly and extracellularly [ 31 ]. Evidence has indicated that ferritin may play a role in cancer proliferation and immunosuppression, as well as therapeutic resistance [ 31 ].…”

“…Both studies showed that high ferritin levels were associated with poor survival in both resectable CRC [ 31 ] and mCRCs [ 43 ]. It is worth noting that when stratified by TNM stages, ferritin levels remained statistically significant with only stage III patients [ 31 ]. Haptoglobin, on the other hand, was also associated with poor survival.…”