Prognostic Value of Primary Tumor Sidedness for Unresectable Stage IV Colorectal Cancer: A Retrospective Study

Shida, Dai; Tanabe, Taro; Boku, Narikazu; Takashima, Atsuo; Yoshida, Takefumi; Tsukamoto, Shunsuke; Kanemitsu, Yukihide

doi:10.1245/s10434-019-07209-x

Cited by 30 publications

(30 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Differences in survival outcomes were assessed with the log-rank test and adjusted using Bonferroni correction. Multivariable Cox proportional hazards regression models were used to evaluate the relationship between longitudinal changes in inflammation-based prognostic markers and OS or RFS, adjusting for potential confounding covariates such as tumour site, 20 preoperative CEA levels, 21 histologic differentiation, 16 T categories, 16 N categories 16 and use of adjuvant chemotherapy. 21 Results are presented as hazard ratios (HRs) with 95% confidence intervals (CIs).…”

Section: Discussionmentioning

confidence: 99%

Postoperative, but not preoperative, inflammation-based prognostic markers are prognostic factors in stage III colorectal cancer patients

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Recent evidence suggests that both preoperative and postoperative inflammation-based prognostic markers are useful for predicting the survival of colorectal cancer (CRC) patients. However, associations between longitudinal changes in inflammation-based prognostic markers and prognosis are controversial. Methods The subjects of this study were 568 patients with stage III CRC between 2008 and 2014. Preoperative and postoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), C-reactive protein/albumin ratio (CAR) and lymphocyte-to-C-reactive protein ratio (LCR) were calculated to assess the inflammatory state of subjects. Subjects were stratified into three groups for each marker: preoperatively low inflammatory state (normal group), preoperatively high but postoperatively low inflammatory state (normalised group) and persistently high inflammatory state (elevated group). Multivariable analyses for overall survival (OS) and recurrence-free survival (RFS) were performed to adjust for well-established clinicopathologic factors. Results For all assessed markers, the normalised group had a significantly better prognosis than the elevated group and a similar prognosis as the normal group for both OS and RFS. Conclusions Postoperative, but not preoperative, inflammation-based prognostic markers more accurately predict OS and RFS in patients with stage III CRC.

show abstract

Section: Discussionmentioning

confidence: 99%

Postoperative, but not preoperative, inflammation-based prognostic markers are prognostic factors in stage III colorectal cancer patients

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Multivariate analyses were performed using Cox proportional hazards regression models to evaluate the prognostic impact of each factor on OS. The following known factors were included: age [1], gender, BMI, ECOG performance status, location of primary tumor [24], CEA levels [21], histological type, M category [22], and surgical treatment, as well as CONUT score, PNI, and mGPS, given the overlap in elements constituting each measure.…”

Section: Discussionmentioning

confidence: 99%

Nutritional and inflammatory measures predict survival of patients with stage IV colorectal cancer

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background This study aimed to evaluate the prognostic impact of nutritional and inflammatory measures (controlling nutritional status (CONUT) score, prognostic nutritional index (PNI), and modified Glasgow prognostic score (mGPS)) on overall survival (OS) in patients with stage IV colorectal cancer (CRC). Methods Subjects were 996 patients with stage IV CRC who were referred to the National Cancer Center Hospital between 2001 and 2015. We retrospectively investigated correlations between OS and CONUT score, PNI, and mGPS. Multivariate analyses were performed using Cox proportional hazards regression models. Results After adjusting for known factors (age, gender, BMI, ECOG performance status, location of primary tumor, CEA levels, histological type, M category, and prior surgical treatment), all three measures were found to be independent prognostic factors for OS in patients with stage (CONUT score, p < 0.001; PNI, p < 0.001; mGPS, p < 0.001). Significant differences in OS were found between low CONUT score (0/1) (n = 614; 61%) and intermediate CONUT score (2/3) (n = 276; 28%) (hazard ratio (HR) = 1.20, 95% confidence interval (CI): 1.02–1.42, p = 0.032), and intermediate CONUT score and high CONUT score (≥4) (n = 106; 11%) (HR = 1.30, 95% CI: 1.01–1.67, p = 0.045). Significant differences in OS were found between mGPS = 0 (n = 633; 64%) and mGPS = 1 (n = 234; 23%) (HR = 1.84, 95% CI: 1.54–2.19, p < 0.001), but not between mGPS = 1 and mGPS = 2 (n = 129; 13%) (HR = 1.12, 95% CI: 0.88–1.41, p = 0.349). Patients with low PNI (< 48.0) (n = 443; 44%) showed a significantly lower OS rate than those with high PNI (≥48.0) (n = 553; 56%) (HR = 1.39, 95% CI: 1.19–1.62, p < 0.001). Conclusions CONUT score, PNI, and mGPS were found to be independent prognostic factors for OS in patients with stage IV CRC, suggesting that nutritional and inflammatory status is a useful host-related prognostic indicator in stage IV CRC.

show abstract

“…The hazard function (smoothed hazard estimate) of recurrence or death, which conveys the instantaneous conditional recurrence or death rate at time t , was also analyzed and expressed as the number of events per unit of time (months). Propensity score matching analysis was conducted in order to balance the distribution of covariates between the normal preoperative CEA group and elevated preoperative CEA group (which included the normalized and elevated subgroups), as described previously . Multivariable logistic regression was used to generate propensity score‐predicting preoperative CEA status based on confounding covariates, including sex (male vs female), procedure (sphincter‐preserving vs non‐preserving), lymphatic invasion (present vs absent), venous invasion (present vs absent), and TNM stage (I/II vs III).…”

Section: Methodsmentioning

confidence: 99%

Prognostic impact of preoperatively elevated and postoperatively normalized carcinoembryonic antigen levels following curative resection of stage I‐III rectal cancer

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background: Preoperative and early postoperative serum carcinoembryonic antigen (CEA) levels are known prognostic factors in rectal cancer. Recently, a large-scale study on colon cancer revealed that "preoperatively elevated and postoperatively normalized CEA levels" is not an indicator of poor prognosis. However, whether this hold true in rectal cancer patients is unknown. This study aimed to investigate the prognostic significance of preoperatively elevated and postoperatively normalized CEA levels in rectal cancer patients undergoing curative resection. Methods: Subjects were consecutive stage I-III rectal cancer patients who underwent curative resection without preoperative treatment at National Cancer Center Hospital between 2000 and 2015. Overall survival (OS) and the hazard function of recurrence or death were analyzed according to the CEA levels, as follows: normal preoperative CEA (normal group), preoperatively elevated but postoperatively normalized CEA (normalized group), and preoperatively and postoperatively elevated CEA (elevated group).Results: The normalized group (n =235) had worse OS (HR 1.49, 95% CI 1.08-2.04; P = .0142) compared to the normal group (n = 1208), and better OS compared to the elevated group (n = 47) (HR 0.53, 95% CI 0.31-0.91; P = .0208). The elevated group had the highest and earliest peak in hazard function, followed by the normalized group and the normal group, with median times to recurrence of 8.8, 15.5, and 18.5 months, respectively (P = .0223). Conclusions: Prognosis after resection of rectal cancer was worse in patients with preoperatively elevated and postoperatively normalized CEA compared to those with normal preoperative CEA. Patients with elevated preoperative CEA might require intensive follow-up even if levels normalize after resection, especially in earlier periods, for early detection of recurrence. |NAKAMURA et Al.

show abstract

Prognostic Value of Primary Tumor Sidedness for Unresectable Stage IV Colorectal Cancer: A Retrospective Study

Cited by 30 publications

References 20 publications

Postoperative, but not preoperative, inflammation-based prognostic markers are prognostic factors in stage III colorectal cancer patients

Postoperative, but not preoperative, inflammation-based prognostic markers are prognostic factors in stage III colorectal cancer patients

Nutritional and inflammatory measures predict survival of patients with stage IV colorectal cancer

Prognostic impact of preoperatively elevated and postoperatively normalized carcinoembryonic antigen levels following curative resection of stage I‐III rectal cancer

Contact Info

Product

Resources

About