Background: Colorectal cancer is one of the most important malignant tumours in adults and the median survival of patients with advanced disease is lower than 24 months. This study was conducted to evaluate potential prognostic factors for survival (OS) and time to progression (TTP) in patients with metastatic or locally advanced colorectal cancer (ACRC). Methods: A retrospective analysis of 453 patients with ACRC, treated from January 1994 to May 2004 with different chemotherapy schedules, was performed. Twenty-six clinical, laboratory and tumour-related parameters were investigated by multivariate logistic regression. Results: In multivariate analysis for TTP, only increased CEA levels at 6 months from first-line chemotherapy was retained an independently significant variable. In multivariate analysis for OS, a low baseline haemoglobin level (less of 12 g/dl) and increased CEA levels at 3 and 6 months from first-line chemotherapy were independent adverse prognostic factors. According to the Kaplan-Meier analysis for OS, were associated with poor survival: low performance status (ECOG more than 1), mucinous histological pattern, low baseline haemoglobin levels, elevated alkaline phosphatase levels, elevated lactic dehydrogenase levels, eosinophil count (more than 500/ul), elevated baseline CEA and Ca19–9 levels, CEA levels after 3 months and 6 months and Ca19–9 levels after 3 and 6 months from first-line chemotherapy, non-response to first-line chemotherapy and progression to first-line chemotherapy. Lung metastases alone were associated with better survival. Conclusions: These parameters could be helpful to identify different risk groups and to select more or less intensive treatments
Prognostic factors in advanced colorectal carcinoma: A multifactorial analysis
TAMPELLINI, MARCO;ALABISO, Oscar
2005-01-01
Abstract
Background: Colorectal cancer is one of the most important malignant tumours in adults and the median survival of patients with advanced disease is lower than 24 months. This study was conducted to evaluate potential prognostic factors for survival (OS) and time to progression (TTP) in patients with metastatic or locally advanced colorectal cancer (ACRC). Methods: A retrospective analysis of 453 patients with ACRC, treated from January 1994 to May 2004 with different chemotherapy schedules, was performed. Twenty-six clinical, laboratory and tumour-related parameters were investigated by multivariate logistic regression. Results: In multivariate analysis for TTP, only increased CEA levels at 6 months from first-line chemotherapy was retained an independently significant variable. In multivariate analysis for OS, a low baseline haemoglobin level (less of 12 g/dl) and increased CEA levels at 3 and 6 months from first-line chemotherapy were independent adverse prognostic factors. According to the Kaplan-Meier analysis for OS, were associated with poor survival: low performance status (ECOG more than 1), mucinous histological pattern, low baseline haemoglobin levels, elevated alkaline phosphatase levels, elevated lactic dehydrogenase levels, eosinophil count (more than 500/ul), elevated baseline CEA and Ca19–9 levels, CEA levels after 3 months and 6 months and Ca19–9 levels after 3 and 6 months from first-line chemotherapy, non-response to first-line chemotherapy and progression to first-line chemotherapy. Lung metastases alone were associated with better survival. Conclusions: These parameters could be helpful to identify different risk groups and to select more or less intensive treatments
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