Prognostic Significance of C-reactive Protein/Albumin Ratio in Patients with Locally Advanced Unresectable Colorectal Cancer

被引:2
作者
Ikeguchi M. [1 ]
Ashida K. [2 ]
机构
[1] Tottori Prefectural Central Hospital, 730 Ezu, Tottori
[2] Department of Surgery, Division of Surgical Oncology, Faculty of Medicine, Tottori University, Yonago
关键词
Chemotherapy; Colorectal cancer; Conversion therapy; Inflammation; Prognosis;
D O I
10.1007/s13193-017-0639-0
中图分类号
学科分类号
摘要
Despite the poor prognosis of unresectable colorectal cancer (CRC), some patients survive after intensive chemotherapy followed by complete resection of the primary and metastatic tumors. The pretreatment C-reactive protein/albumin ratio (CAR) is a significant prognostic indicator in various carcinomas. Therefore, in this retrospective study, we evaluated the prognostic significance of pretreatment CAR in patients with unresectable CRC. The 61 patients were diagnosed as having initially unresectable disease between January 2004 and December 2013. We analyzed the clinical courses of these patients. Blood samples were taken routinely at their first visit to our hospital. C-reactive protein (CRP), albumin (ALB), and carcinoembryonic antigen (CEA) were analyzed. The median survival time (MST) and 2-year overall survival (OS) of the patients was 9 months (range, 1–96 months) and 23%, respectively. The median CRP, ALB, CAR, and CEA levels of the patients were 2.2 mg/dL, 3.5 g/dL, 0.65, and 20.6 ng/mL, respectively. There was no correlation between CEA levels and the CAR. Patients were divided into two sub-groups using the median CAR level as the cut-off: high CAR (>0.65) and low CAR (≤0.65). Both MST and 2-year OS were significantly lower in the 30 high-CAR patients (4 months, 6.7%) than in the 31 low-CAR patients (13 months, 38.7%, p < 0.001). The primary tumors of three low-CAR patients could be removed after intensive chemotherapy. Thus, low-CAR patients with locally advanced CRC with or without distant metastasis may survive following intensive treatment, even if their tumors were previously deemed to be unresectable. © 2017, Indian Association of Surgical Oncology.
引用
收藏
页码:263 / 266
页数:3
相关论文
共 12 条
[1]  
de Gramont A., Figer A., Seymour M., Homerin M., Hmissi A., Cassidy J., Boni C., Cortes-Funes H., Cervantes A., Freyer G., Papamichael D., Le Bail N., Louvet C., Hendler D., de Braud F., Wilson C., Morvan F., Bonetti A., Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer, J Clin Oncol, 18, pp. 2938-2947, (2000)
[2]  
Douillard J.Y., Siena S., Cassidy J., Tabernero J., Burkes R., Barugel M., Humblet Y., Bodoky G., Cunningham D., Jassem J., Rivera F., Kocakova I., Ruff P., Blasinska-Morawiec M., Smakal M., Canon J.L., Rother M., Oliner K.S., Wolf M., Gansert J., Randomized, phase III trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as first-line treatment in patients with previously untreated metastatic colorectal cancer: the PRIME study, J Clin Onc
[3]  
Gockel I., Dirksen K., Messow C.M., Junginger T., Significance of preoperative C-reactive protein as a parameter of the perioperative course and long-term prognosis in squamous cell carcinoma and adenocarcinoma of the oesophagus, World J Gastroenterol, 12, pp. 3746-3750, (2006)
[4]  
Hwang J.E., Kim H.N., Kim D.E., Choi H.J., Jung S.H., Shim H.J., Bae W.K., Hwang E.C., Cho S.H., Chung I.J., Prognostic significance of a systemic inflammatory response in patients receiving first-line palliative chemotherapy for recurred or metastatic gastric cancer, BMC Cancer, 11, (2011)
[5]  
Chen Z., Shao Y., Fan M., Zhuang Q., Wang K., Cao W., Xu X., He X., Prognostic significance of preoperative C-reactive protein: albumin ratio in patients with clear cell renal cell carcinoma, Int J Clin Exp Pathol, 8, pp. 14893-14900, (2015)
[6]  
Nozoe T., Kohno M., Iguchi T., Mori E., Maeda T., Matsukuma A., Ezaki T., The prognostic nutritional index can be a prognostic indicator in colorectal carcinoma, Surg Today, 42, pp. 532-535, (2012)
[7]  
Maeda K., Shibutani M., Otani H., Nagahara H., Sugano K., Ikeya T., Kubo N., Amano R., Kimura K., Muguruma K., Tanaka H., Hirakawa K., Low nutritional prognostic index correlates with poor survival in patients with stage IV colorectal cancer following palliative resection of the primary tumor, World J Surg, 38, pp. 1217-1222, (2014)
[8]  
Hsu C.W., King T.M., Wang H.T., Wang J.H., Factors that influence survival in unresectable metastatic or locally advanced colorectal cancer, Int J Color Dis, 26, pp. 1559-1566, (2011)
[9]  
Kishiki T., Masaki T., Matsuoka H., Kobayashi T., Suzuki Y., Abe N., Mori T., Sugiyama M., Modified Glasgow prognostic score in patients with incurable stage IV colorectal cancer, Am J Surg, 206, pp. 234-240, (2013)
[10]  
La Torre M., Nigri G., Cavallini M., Mercantini P., Ziparo V., Ramacciato G., The Glasgow prognostic score as a predictor of survival in patients with potentially resectable pancreatic adenocarcinoma, Ann Surg Oncol, 19, pp. 2917-2923, (2012)