The Elevation in Preoperative Procalcitonin Is Associated with a Poor Prognosis for Patients Undergoing Resection for Colorectal Cancer

Abstract

<b><i>Background:</i></b> Procalcitonin (PCT) is a well-known marker for bacterial infection; however, the clinical significance of PCT in the long-term prognosis after colorectal cancer (CRC) surgery remains unclear. <b><i>Methods:</i></b> This is a retrospective review of 277 patients that underwent CRC surgery to investigate the relationship between preoperative PCT, clinicopathological condition, cancer-specific overall survival (OS), and relapse-free survival (RFS). <b><i>Results:</i></b> Median follow-up interval was 5.0 years in all patients. Thirty-six patients developed recurrence, and 46 patients died due to recurrences or metastases of CRC. Preoperative PCT levels were highest in Stage IV patients. The cancer-specific OS in patients with Stage IV/PCT ≤0.05 ng/mL was significantly higher than those with Stage IV/PCT >0.05 ng/mL (3 years survival; 42.3 vs. 14.3%, <i>p</i> = 0.0413). On multivariate analysis, gender, TNM classification, and PCT were identified as significant risk factors for cancer-specific OS in patients with Stage I–III CRC. The cancer-specific OS rate of these patients with PCT ≥0.08 ng/mL, compared with PCT <0.08 ng/mL, was significantly decreased (5 years survival; 59.1 vs. 92.7%, <i>p</i> < 0.0001). TNM classification was finally identified as an independent risk factor for cancer-specific RFS in these patients by multivariate analysis. <b><i>Conclusion:</i></b> High preoperative PCT values in CRC patients appeared to be associated with poor OS but not RFS following surgical treatments.

Prognostic value of post-operative serum procalcitonin in gastric adenocarcinoma patients undergoing radical gastrectomy: propensity score matching analysis of extended cohort from a prospective bi-center study

“…In a prospective population-based study that enrolled 3322 patients [32], the baseline PCT was found to be significantly associated with all-cause mortality and cancer-related mortality in men after a median follow-up time of 16.2 years. In a retrospective study of 277 colorectal cancer patients who received surgery, the pre-operative PCT concentration was identified as a significant predictor for cancer-specific survival in stages I to III of the disease [15]. In another retrospective study consisting of 95 metastatic NSCLC patients who received immune-check point inhibitors, a baseline PCT concentration of > 0.1 mg/L was confirmed to result in significantly worse outcomes in terms of OS [33].…”

“…In recent years, many studies have highlighted the predictive role of PCT on the prognosis of several cancers, such as medullary thyroid cancer, NSCLC, colorectal cancer, neuroendocrine neoplasms, and so on [12][13][14][15]31]. In a prospective population-based study that enrolled 3322 patients [32], the baseline PCT was found to be significantly associated with all-cause mortality and cancer-related mortality in men after a median follow-up time of 16.2 years.…”

“…In recent years, more and more studies have reported that various types of cancers secret PCT and that PCT is a reliable predictor for long term survival, including for medullary thyroid cancer, colorectal cancer, non-small cell lung cancer (NSCLC), and others [12][13][14][15]. But whether the serum concentration of PCT was related to the oncological outcomes of GA patients has never been investigated.…”

Postoperative serum interleukin-6 levels correlate with survival in stage I-III colorectal cancer

“…Interestingly, most previous studies have explored the prognostic value of CRP, PCT and IL-6 levels individually for CRC in the preoperative setting [ 4 , 5 ] and have yielded inconsistent results when considered together. For example, the study by Groblewska et al indicated that CRP was the only independent risk factor for survival when compared to IL-6 [ 6 ]; in contrast, the study by Lee et al suggested that IL-6 but not CRP, was an independent risk factor for disease-free survival (DFS) in stage III patients [ 7 ].…”