Risk factors for recurrence in stage II/III colorectal cancer patients treated with curative surgery: The impact of postoperative tumor markers and an infiltrative growth pattern

Tokodai, Kazuaki; Narimatsu, Hiroto; Nishida, Akiko; Takaya, Kai; Hara, Yasuyuki; Kawagishi, Naoki; Hashizume, Eiji; Ohuchi, Noriaki

doi:10.1002/jso.24320

Cited by 21 publications

(17 citation statements)

References 21 publications

(31 reference statements)

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“…However, the 5-year survival rate at stage IV is extremely poor (~ 18.8%) [ 6 ]. Moreover, CRCs recur after surgical resection in ~ 10% of patients with stage II disease and in ~ 20–40% with stage IIIa–IIIb disease; hence, recurrence remains an important concern [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative dynamics and significance of plasma-free amino acid profiles in colorectal cancer

et al. 2018

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BackgroundFor early detection of cancer, we have previously developed the AminoIndex Cancer Screening (AICS) system, which quantifies 6 plasma-free amino acids (PFAAs) in blood samples. Herein, we examined the usefulness of the AICS in patients with colorectal cancer (CRC) by comparing the preoperative and postoperative PFAA profiles.MethodsOur study cohort consisted of 62 patients who had undergone curative resection for CRC at our cancer center, with no recurrence at the time of the study. Blood samples were collected from fasted patients within 1 week before the resection and at 0.5–6.5 years post-resection. Following plasmapheresis, the PFAA levels were measured via liquid chromatography/mass spectrometry, and the AICS values were computed (the higher the value, the greater the probability of cancer). Risk was calculated from the AICS value and ranked as A, B, or C, with rank C representing the highest risk. All patients in our study were rank B + C.ResultsThe postoperative AICS value was lower than the preoperative value in 57 of the 62 patients; the rank was also lower postoperatively (49 patients, p < 0.001). The decline in both was stage-independent, even occurring in patients with right-sided tumors or poorly differentiated adenocarcinomas. For comparative purposes, the levels of 2 tumor markers (carbohydrate antigen 19–9 and carcinoembryonic antigen) were also examined; these were within the reference ranges in 70–80% of patients preoperatively and in 80–90% postoperatively.ConclusionWe suggest that tumor-bearing conditions alter the PFAA profiles, which may be used to predict prognosis and monitor for recurrence in CRC patients after tumor resection.Trial registrationThis trial has been retrospectively registered at UMIN-CTR R000028005, Oct 06, 2016.Electronic supplementary materialThe online version of this article (10.1186/s12893-018-0344-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Perioperative dynamics and significance of plasma-free amino acid profiles in colorectal cancer

et al. 2018

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“…Besides, several studies have shown that the degree of parietal invasion was significantly associated with the risk of recurrence [27, 28]. A recent study by Chen et al involving 359 patients operated for rectal cancer showed that the T3 stage has a higher risk of recurrence compared to the T2 stage ( p = 0.012) [3].…”

Section: Discussionmentioning

confidence: 99%

Factors predicting recurrence after curative resection for rectal cancer: a 16-year study

et al. 2019

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BackgroundThe recurrence after curative surgery of the rectal adenocarcinoma is a serious complication, considered as a failure of the therapeutic strategy. The aim of this study was to identify the different prognostic factors affecting the recurrence of adenocarcinoma of the rectum.MethodsA retrospective analysis of patients operated for adenocarcinoma of the rectum between January 2000 and December 2015 was conducted. The study of the recurrence rate and prognostic factors was performed through the Kaplan Meier survival curve and the Cox regression analysis.ResultsDuring the study period, 188 patients underwent curative surgery for rectal adenocarcinoma, among which 53 had a recurrence. The recurrence rate was 44.6% at 5 years. The multivariate analysis identified four parameters independently associated with the risk of recurrence after curative surgery: a distal margin ≤ 2 cm (HR = 6.8, 95% CI 2.7–16.6, 6), extracapsular invasion of lymph node metastasis (HR = 4.4, 95% CI 1.3–14), tumor stenosis (HR = 4.3, 95% CI 1.2–15.2), and parietal invasion (pT3/T4 disease) (HR = 3, 95% CI 1.1–9.4).ConclusionThe determination of the prognostic factors affecting the recurrence of rectal adenocarcinoma after curative surgery allows us to define the high-risk patients for recurrence.Trial registrationClinicalTrials.gov Identifier: NCT03899870. Registered on 2 February 2019, retrospectively registered.

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“…Colorectal cancer (CRC) is the third most common cancer worldwide, the fourth cause of cancer-related deaths [1], and is expected to increase by 60% by 2030 [2]. Even after radical resection, CRC recurrence is still a major concern [3,4]. The treatments for CRC include surgery, chemotherapy and/or radiotherapy, which are invasive treatments often associated with adverse side effects.…”

Section: Introductionmentioning

confidence: 99%

Oxaliplatin-Fluoropyrimidine Combination (XELOX) Therapy Does Not Affect Plasma Amino Acid Levels and Plasma Markers of Oxidative Stress in Colorectal Cancer Surgery Patients: A Pilot Study

et al. 2019

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Chemotherapy for colorectal cancer may lower muscle protein synthesis and increase oxidative stress. We hypothesize that chemotherapy may worsen plasma amino acids (AAs) and markers of oxidative stress (MOS). Therefore, this study aimed to document plasma AAs and MOS before, during and after chemotherapy in colorectal cancer (CRC) surgery patients. Fourteen normal-weight CRC patients were enrolled one month after surgery and scheduled for oxaliplatin-fluoropyrimidine combination (XELOX) therapy. Venous blood samples for AA and MOS (malondialdehyde, MDA; 8-hydroxy-2’-deoxyguanosine, 8-OHdG) measurements were drawn in fasting patients before each oxaliplatin infusion at initiation (A), 1 month (B) and 3 months (C) of the therapy, and after XELOX had finished (6 months, D). The results showed that during XELOX therapy (from phase B to phase D), in comparison to baseline (phase A), the branched chain amino acid/essential amino acid ratio, branched chain amino acids expressed as a percentage of total AAs, and arginine expressed as a percentage of total AAs significantly decreased (p = 0.017, p = 0.028, p = 0.028, respectively). Plasma levels of MOS did not change significantly. This study indicates that XELOX therapy does not affect plasma AA levels or worsen oxidative stress.

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Risk factors for recurrence in stage II/III colorectal cancer patients treated with curative surgery: The impact of postoperative tumor markers and an infiltrative growth pattern

Cited by 21 publications

References 21 publications

Perioperative dynamics and significance of plasma-free amino acid profiles in colorectal cancer

Perioperative dynamics and significance of plasma-free amino acid profiles in colorectal cancer

Factors predicting recurrence after curative resection for rectal cancer: a 16-year study

Oxaliplatin-Fluoropyrimidine Combination (XELOX) Therapy Does Not Affect Plasma Amino Acid Levels and Plasma Markers of Oxidative Stress in Colorectal Cancer Surgery Patients: A Pilot Study

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