The prognostic value of serum IL-6 and YKL-40 in colorectal cancer patients before liver resection.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15078-e15078
Author(s):  
Mathias Holsey Gramkow ◽  
Reetta Peltonen ◽  
Christian Dehlendorff ◽  
Pia J. Osterlund ◽  
Julia S. Johansen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Liver Resection ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Elevated Serum ◽  
Disease Free Survival ◽  
Markers Of Inflammation ◽  
Preoperative Serum ◽  
Serum Cea

e15078 Background: IL-6 and YKL-40, markers of inflammation and cancer growth, are high in serum in patients with colorectal cancer (CRC) and associated with shorter overall survival (OS). We hypothesized that preoperative serum IL-6, YKL-40 and CEA are associated with disease free survival (DFS) and OS in patients with metastatic (mCRC) treated with liver resection. Methods: 457 patients (male/female: 267 (58%)/190 (42%), median age 65 [IQR: 58-71]) diagnosed with mCRC who underwent liver resection were included between March 1998 and February 2013. Preoperative serum samples were collected and stored at -80°C until analysis. Serum IL-6 (R&D Systems, UK) and YKL-40 (Quidel, USA) were determined by ELISA. For DFS and OS we estimated crude and adjusted hazard ratios (HR) and corresponding 95% confidence intervals (CIs) with Cox regression for each biomarker separately. The biomarkers were included as log2-transformed continuous variables and adjustment included mutual adjustment between the biomarkers in addition to adjusting for sex and age. Results: The median (IQR) preoperative biomarker levels were: IL-6 (3.5 pg/ml, 2.1-6.1), YKL-40 (75 ng/ml, 48-127) and CEA (5.2 kU/L, 2.6-18.8). Univariate analysis showed that high serum IL-6 and YKL-40 were associated with shorter DFS (IL-6: HR = 1.18, 1.06-1.31, p < 0.01; YKL-40: HR = 1.19, 1.08-1.32, p < 0.01). Serum CEA was not (p = 0.80). Multivariate analysis (all biomarkers) showed that high IL-6 was associated with shorter DFS (HR = 1.15, 1.02-1.29, p = 0.02), whereas YKL-40 (p = 0.08) and CEA (p = 0.51) were not. Univariate analysis showed that high preoperative serum IL-6 and YKL-40 were associated with shorter OS (IL-6: HR = 1.16, 1.03-1.29, p = 0.01; YKL-40: HR = 1.27, 1.14-1.42, p < 0.01). Serum CEA was not associated with OS (p = 0.16). Multivariate analysis (all biomarkers) showed that high YKL-40 was associated with shorter OS (HR = 1.19, 1.05-1.34, p = 0.01), whereas IL-6 (p = 0.25) and CEA (p = 0.26) were not. Patients with elevated serum levels of all 3 biomarkers had the shortest OS (HR = 2.12; 1.29-3.50, p < 0.01). Conclusions: Serum IL-6 and YKL-40 determined before liver resection may be valuable prognostic biomarkers in patients with metastatic CRC.

scholarly journals Prognostic indices of inflammatory markers, cognitive function and fatigue for survival in patients with localised colorectal cancer

ESMO Open ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. e000302 ◽  
Author(s):  
Janette L Vardy ◽  
Haryana Mary Dhillon ◽  
Gregory R Pond ◽  
Corrinne Renton ◽  
Stephen J Clarke ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cognitive Function ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Full Blood Count ◽  
Prognostic Impact ◽  
Prospective Longitudinal Study ◽  
Lymphocyte Ratio ◽  
Markers Of Inflammation ◽  
Prospective Longitudinal

BackgroundInflammation promotes the development of malignancy, while a variety of systemic markers of inflammation predict for worse cancer outcomes including recurrence and survival. Here, we evaluate the prognostic impact of cytokine concentrations, full blood count (FBC) differential ratios, cognitive function and fatigue on survival in patients with localised colorectal cancer (CRC).Patients and methodsData are from a prospective longitudinal study comparing cognitive function and fatigue in patients with CRC who did (n=173) and did not (n=116) receive adjuvant/neoadjuvant chemotherapy. Baseline blood results (prior to any chemotherapy) included cytokines and FBC from which neutrophil lymphocyte ratio, lymphocyte monocyte ratio, platelet lymphocyte ratio and platelet monocyte ratio were derived. Fatigue was measured with the Functional Assessment of Cancer Therapy-Fatigue subscale and cognitive function by a neuropsychological test battery. Kaplan-Meier methods were used to estimate disease-free survival (DFS) and overall survival (OS). Univariable and multivariable Cox regression analyses were performed to evaluate factors potentially prognostic of outcomes.ResultsAt a median follow-up of 91.2 months, 227 subjects (79%) are still alive, and 212 (73%) have no evidence of a recurrence. Five-year OS and DFS are 86% (95% CI 81% to 90%) and 77% (95% CI 71% to 82%), respectively. None of the cytokines (interleukin (IL-6), IL-1 and tumour necrosis factor) or differential ratios of blood components, fatigue or cognitive function was statistically related to DFS or OS. Patient educational status (P=0.018), stage of disease (P=0.032), alanine transaminase (P=0.003), lactate dehydrogenase (P=0.008) and carcinoembryonic antigen (P=0.002) were significant as prognostic covariates of OS in univariable analyses, with similar results for DFS.ConclusionNone of the a priori selected markers of inflammation, fatigue or cognitive function was associated with OS or DFS in this cohort of patients.Trial registration numberNCT00188331, Post-results.

Correlation of plasma TIMP-1 levels and disease-free survival in primary colorectal cancer independent of serum CEA levels

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22040-e22040
Author(s):  
H. J. Nielsen ◽  
N. Brünner ◽  
I. J. Christensen
Keyword(s):  
Colorectal Cancer ◽  
Local Recurrence ◽  
Prognostic Markers ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Disease Stage ◽  
Free Survival ◽  
Preoperative Serum ◽  
Serum Cea ◽  
Disease Free

e22040 Background: Introduction of independent prognostic markers may play a significant role in future treatment of early stage colorectal cancer (CRC). CEA is still the only recommended (ASCO and EGTM) serological marker in CRC. However, Tissue Inhibitor of Metallo Proteinases-1 (TIMP-1), which is a glycoprotein that acts as an inhibitor of most of the active matrix metalloproteinases, has previously been shown to carry independent prognostic information in patients with primary CRC. The purpose of the present study was to assess the combination of preoperative serum CEA and plasma TIMP-1as prognostic markers in patients undergoing resection for primary CRC. Methods: In the present prospective study serum and plasma samples were collected before surgery from 422 patients with primary CRC stage I-III. CEA was determined in serum by a commercial assay and TIMP-1 was determined in plasma using a thoroughly validated, in-house ELISA. Time to recurrence or death of CRC was registered and the association to serum CEA and plasma TIMP-1 levels were studied in a Cox multivariate model including age, gender, disease stage and tumor location. Hazard ratios and 95% confidence intervals (HR (95%CI)) for disease free survival (DFS) were calculated. Results: An event was recorded in 186 patients, 75 had local recurrence, 103 had a distant metastases (28 of these patients had both local recurrence and distant metastases) and 36 died from their cancer without a registered recurrence. Scoring CEA and TIMP-1 as continuous variables on a logarithmic scale (base 2), both serum CEA and plasma TIMP-1 were statistically significant in a multivariable analysis with HR=1.12 (1.03–1.21) and HR=1.51 (1.12–2.04), respectively. Additional calculations of low CEA plus low TIMP-1, high CEA plus low TIMP-1, low CEA plus high TIMP-1 and high CEA plus high TIMP-1 showed that high plasma TIMP-1 levels carried prominent information of poor prognosis independent of CEA. Conclusions: Preoperative serum CEA and plasma TIMP-1 levels were independent predictors of disease free survival for patients with primary CRC. Combination of the two proteins showed that TIMP-1 was a prominent predictor of poor DFS independent of CEA. [Table: see text]

Distant metastasis in head and neck cancer: Baseline factors.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16021-e16021
Author(s):  
Rahul Krishnatry ◽  
Tejpal Gupta ◽  
Vedang Murthy ◽  
Sudhir Vasudevan Nair ◽  
Deepa Nair ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Cell Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Rank Test ◽  
Advanced Tumor

e16021 Background: Loco-regional relapse is predominant pattern of failure in locally advanced head & neck squamous cell cancer (HNSCC). Distant metastasis (DM) is increasingly detected on follow-up. this study attempts to identify baseline patient, tumor & treatment characteristics which determine poor survival in radically treated HNSCC patients developing DM. Methods: Clinical outcome audit of HNSCC receiving radical treatment from 1990-2010 in a single HNCC radiotherapy (RT) clinic who developed DM, using electronic search of a prospectively maintained database. The Disease free survival (DFS) & overall survival (OS) were calculated using Kaplan Meier method. The Log rank test & Cox regression (p< 0.05 significant) were used for univariate & multivariate analysis respectively. Results: 104 HNC patients developed DM, baseline characteristics are shown in table 1. DM was detected at a median of 7(IQR 3-14) months from treatment completion & median survival after diagnosis of DM was 2.6 (0-6) months. The median DFS & OS were 19(13-26), 21.5(16-29) months respectively. On univariate analysis, factors affecting DFS & OS were advanced tumor and nodal stage, perinodal extension & treatment factors (surgery & RT gap >30 days). On multivariate analysis stage and PNE remained significant for DFS while only stage showed significance for OS. Conclusions: Locally advanced stage of presentation (stage IV, T4, N2+) is the most important baseline factor determining poor outcome in HNC patients developing DM. Trials for aggressive primary systemic treatment (chemotherapy, targeted agents) are needed. [Table: see text]

scholarly journals A prognostic model for colorectal cancer based on CEA and a 48-multiplex serum biomarker panel

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kajsa Björkman ◽  
Sirpa Jalkanen ◽  
Marko Salmi ◽  
Harri Mustonen ◽  
Tuomas Kaprio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Model ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Learning Technologies ◽  
University Hospital ◽  
Prognostic Models ◽  
Significant Prognostic Factor ◽  
Model Based ◽  
Preoperative Serum

AbstractMortality in colorectal cancer (CRC) remains high, resulting in 860,000 deaths annually. Carcinoembryonic antigen is widely used in clinics for CRC patient follow-up, despite carrying a limited prognostic value. Thus, an obvious need exists for multivariate prognostic models. We analyzed 48 biomarkers using a multiplex immunoassay panel in preoperative serum samples from 328 CRC patients who underwent surgery at Helsinki University Hospital between 1998 and 2003. We performed a multivariate prognostic forward-stepping background model based on basic clinicopathological data, and a multivariate machine-learned prognostic model based on clinicopathological data and biomarker variables, calculating the disease-free survival using the value of importance score. From the 48 analyzed biomarkers, only IL-8 emerged as a significant prognostic factor for CRC patients in univariate analysis (HR 4.88; 95% CI 2.00–11.92; p = 0.024) after correcting for multiple comparisons. We also developed a multivariate model based on all 48 biomarkers using a random survival forest analysis. Variable selection based on a minimal depth and the value of importance yielded two tentative candidate CRC prognostic markers: IL-2Ra and IL-8. A multivariate prognostic model using machine-learning technologies improves the prognostic assessment of survival among surgically treated CRC patients.

The prognostic value of serum IL-6 and YKL-40 in patients with metastatic colorectal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15060-e15060
Author(s):  
Benny Vittrup Jensen ◽  
Mathias Holsey Gramkow ◽  
Camilla Stedstrup Mosgaard ◽  
Christian Dehlendorff ◽  
Per Pfeiffer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Metastatic Colorectal Cancer ◽  
Prognostic Value ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Continuous Variables ◽  
Female Ratio ◽  
Cox Regression Analysis ◽  
L 14

e15060 Background: The prognostic value of serum IL-6, YKL-40 and CEA before first (1) and third line therapy (3LT) in metastatic colorectal cancer (mCRC) is lacking and was evaluated in this study. Methods: From 2004 to 2015 serum samples were collected from 160 and 255 patients with mCRC before 1LT and 3LT, respectively. Median age was 64 years (range 33-87) and male/female ratio 243(59%)/172(41%). Serum IL-6 (R&D, UK) and YKL-40 (Quidel, USA) were determined by ELISA. Progression-free (PFS) and overall survival (OS), crude and adjusted hazard ratios (HR) and corresponding 95% confidence intervals (CI) were estimated with Cox regression analysis. CEA, IL-6 and YKL-40 were included as log2-transformed continuous variables with mutual adjustment between CEA, IL-6 and YKL-40, primary tumor location, sex and age. Results: In 3LT IL-6, YKL-40 and CEA levels were higher (P < 0.001) than in 1LT (IL-6: 9.5 pg/ml [IQR4.2-18.5] vs. 4.6 [2.5-10.5]; YKL-40: 140 ng/ml [77-272] vs. 101 [62-172]; and CEA: 59 ug/l [14-288] vs. 23[5.8-153]). In 3LT univariate analysis showed that increased levels of IL-6, YKL-40 and CEA were associated with shorter PFS (IL-6: HR = 1.19, 95% CI 1.07-1.31, P < 0.01; YKL-40: HR = 1.13, 1.04-1.24, P = 0.01; CEA: HR = 1.05, 1.00-1.09, P = 0.04). In 1LT only high IL-6 was associated with shorter PFS (HR = 1.09, 1.01-1.17, P = 0.03). In a multivariate analysis only high IL-6 was significantly associated with shorter PFS in 3LT (HR = 1.15, 1.03-1.29, P < 0.01) and none of the biomarkers in 1LT. In 3LT univariate analysis showed that increased levels of all 3 biomarkers were associated with a shorter OS (IL-6: HR = 1.36, 1.23-1.51, P < 0.01; YKL-40: HR = 1.21, 1.10-1.33, P < 0.01; CEA: HR = 1.11, 1.06-1.16, P < 0.01). In 1LT high levels of IL-6 (HR = 1.17, 1.08-1.27, P < 0.01) and YKL-40 (HR = 1.18, 1.00-1.38, P = 0.05), but not CEA, were associated with short OS. In 3LT the multivariate analysis showed that both higher IL-6 (HR = 1.34, 1.20-1.50, P < 0.01) and CEA (HR = 1.09, 1.03-1.14, P < 0.01), but not YKL-40 were significantly associated with a shorter OS. In 1LT only higher IL-6 was associated with a shorter OS (HR = 1.19, 1.08-1.31, P < 0.01) Conclusions: Serum IL-6 and YKL-40 may be useful prognostic biomarkers in combination with CEA in patients with mCRC

scholarly journals Prognosis analysis of patients with resectable T4 colorectal cancer

2020 ◽  
Author(s):  
Wei Chen ◽  
Jun-Wen Ye ◽  
Xiao-ping Tan ◽  
Yan Zhang ◽  
Jing-Lin Liang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Independent Factor ◽  
Node Metastasis ◽  
Colorectal Cancer Patients

Abstract Objective: To observe the factors related to survival and prognosis of patients with resectable stage T4 colorectal cancer. Methods : 148 patients with resectable stage T4 colorectal cancer who underwent surgery in the first Affiliated Hospital of Sun Yat-sen University between August, 1994 and December, 2005 were retrospectively analyzed. Univariate and multivariate analyses of associations between clinicopathological variables and survival were analyzed using the Cox regression model. Results: At the end of December of 2010 or death, the 5-year and 10 years OS rates were 49.0% and 32.2% respectively, the median OS was 25 months. The disease free survival rates (DFS) at 5 and 10 years were 44.2% and 30.3% respectively. In univariate analysis, patients with postoperative pathology lymph node metastasis was associated with the prognosis of patients with OS (all P< 0.01), postoperative adjuvant therapy failed to improve OS and DFS (P>0.05). Postoperative pathology lymph node metastasis was associated with DFS too (all P< 0.01). In multivariate analysis, postoperative pathology lymph node metastasis was independent factor affected OS and DFS in colorectal cancer patients. Conclusion: Postoperative prognosis of T4 colorectal cancer patients is poor, postoperative pathology lymph node positive was an independent factor affect OS and DFS.

scholarly journals Clinical Significance of Serum Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Levels Before Surgery and During Postoperative Follow-Up in Colorectal Cancer

2018 ◽  
Vol 103 (7-8) ◽  
pp. 322-330
Author(s):  
Harunobu Sato ◽  
Yoshikazu Koide ◽  
Miho Shiota ◽  
Hiroshi Takahashi ◽  
Zenichi Morise ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Carcinoembryonic Antigen ◽  
Disease Free Survival ◽  
Carbohydrate Antigen ◽  
Preoperative Serum ◽  
Serum Carcinoembryonic Antigen ◽  
Group A ◽  
Serum Cea ◽  
Group B

Objective: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are the most common colorectal cancer markers. We aimed to identify the appropriate clinical conditions for measuring serum CEA and CA19-9 levels before surgery and during follow-up. Methods: This study included 1275 colorectal cancer patients who were divided into 3 groups according to preoperative CEA levels (group A, ≤5 ng/mL; group B, &gt;5–≤11 ng/mL; group C, &gt;11 ng/mL). Each group was subdivided into 2 groups according to preoperative CA19-9 levels (cutoff level: ≤37 U/mL). Recurrence and survival rates were analyzed. Results: Recurrence rate, disease-free survival after curative surgery, and prognosis were significantly worse in group A and B patients with high CA19-9 levels. At recurrence, CEA levels showed a greater increase in group B and C patients; CA19-9 levels increased in group A patients with high CA19-9 levels. At recurrence, high serum CA19-9 levels were observed in group A patients with high preoperative serum CA19-9 levels, even if the serum CEA level did not increase. Preoperative CA19-9 levels could predict recurrence and prognosis in groups A and B. Conclusion: Periodic CA19-9 determination is useful for monitoring recurrence among group A patients with high CA19-9 levels.

scholarly journals Serum carcinoembryonic antigen to predict recurrence in the follow-up of patients with colorectal cancer

2019 ◽  
Vol 34 (1) ◽  
pp. 60-68 ◽  
Author(s):  
Winesh Ramphal ◽  
Jeske R.E. Boeding ◽  
Maartje van Iwaarden ◽  
Jennifer M.J. Schreinemakers ◽  
Harm J.T. Rutten ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Disease Free Survival ◽  
Curative Surgery ◽  
Free Survival ◽  
Preoperative Serum ◽  
Serum Carcinoembryonic Antigen ◽  
Postoperative Serum ◽  
Serum Cea ◽  
Disease Free

Introduction: Serum carcinoembryonic (CEA) antigen is used as a diagnostic screening tool during follow-up in colorectal cancer patients. However, it remains unclear whether preoperative serum CEA is a reliable marker in the follow-up to predict recurrence. The aim of the study is to determine the value of elevated pre- and postoperative serum carcinoembryonic antigen levels (CEA > 5 µg/L) as an independent prognostic factor for locoregional and distant recurrence in patients who underwent curative surgery for colorectal cancer. Methods: This single center retrospective observational cohort study includes patients who underwent curative surgery for colorectal cancer between 2005 and 2015 and had pre- and postoperative serum CEA measurements. Five-year disease-free survival and multivariate Cox regression analyses were performed to adjust for confounding factors. Results: Preoperative serum CEA level was measured in 2093 patients with colorectal cancer. No significant association was found between an elevated preoperative serum CEA and locoregional recurrence (adjusted hazard ratio (HR) 1.29 (95% confidence interval (CI) 0.91, 1.84; P=0.26)). However, a significant association was found between an elevated preoperative serum CEA and systemic recurrence (adjusted HR 1.58 (95% CI 1.25, 2.00; P<0.01)]. The five-year disease-free survival was lower in patients with elevated preoperative serum CEA levels ( P<0.01). Postoperative serum CEA level was the most sensitive for hepatic metastases during follow-up (73.3%). Conclusions: The preoperative serum CEA level is an independent prognostic factor for systemic metastasis after curative surgery for colorectal cancer in patients with stage I–III disease. The level is the most sensitive for hepatic metastasis compared to metastasis to other anatomic sites.

scholarly journals The Change of Systemic Immune-Inflammation Index Independently Predicts Survival of Colorectal Cancer Patients after Curative Resection

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Qingqing Chen ◽  
Haohao Wu ◽  
Xinwei Guo ◽  
Ke Gu ◽  
Wenjie Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Therapy ◽  
Vascular Invasion ◽  
Curative Resection ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Immune Inflammation ◽  
Pathological Stages

Background. The systemic immune-inflammation index (SII) has an important role in predicting survival in some solid tumors. However, little information is available concerning the change of the SII (∆SII) in colorectal cancer (CRC) after curative resection. This study was designed to evaluate the role of ∆SII in CRC patients who received surgery. Methods. A total 206 patients were enrolled in this study. Clinicopathologic characteristics and survival were assessed. The relationships between overall survival (OS), disease-free survival (DFS), and ∆SII were analyzed with both univariate Kaplan-Meier and multivariate Cox regression methods. Results. Based on the patient data, the receiver operating characteristic (ROC) optimal cutoff value of ∆SII was 127.7 for OS prediction. The 3-year and 5-year OS rates, respectively, were 60.4% and 36.7% in the high-∆SII group (>127.7) and 87.6% and 79.8% in the low-∆SII group (≤127.7). The 3-year and 5-year DFS rates, respectively, were 54.1% and 34.1% in the high-∆SII group and 80.3% and 78.5% in the low-∆SII group. In the univariate analysis, smoking, pathological stages III-IV, high-middle degree of differentiation, lymphatic invasion, vascular invasion, and the high-ΔSII group were associated with poor OS. Adjuvant therapy, pathological stages III-IV, vascular invasion, and ΔSII were able to predict DFS. Multivariate analysis revealed that pathological stages III-IV ( HR = 0.442 , 95% CI = 0.236 -0.827, p = 0.011 ), vascular invasion ( HR = 2.182 , 95% CI = 1.243 -3.829, p = 0.007 ), and the high-ΔSII group ( HR = 4.301 , 95% CI = 2.517 -7.350, p < 0.001 ) were independent predictors for OS. Adjuvant therapy ( HR = 0.415 , 95% CI = 0.250 -0.687, p = 0.001 ), vascular invasion ( HR = 3.305 , 95% CI = 1.944 -5.620, p < 0.001 ), and the high-ΔSII group ( HR = 4.924 , 95% CI = 2.992 -8.102, p < 0.001 ) were significant prognostic factors for DFS. Conclusions. The present study demonstrated that ∆SII was associated with the clinical outcome in CRC patients undergoing curative resection, supporting the role of ∆SII as a prognostic biomarker.

Sign in / Sign up

Export Citation Format

Share Document