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The Elevation in Preoperative Procalcitonin Is Associated with a Poor Prognosis for Patients Undergoing Resection for Colorectal Cancer
Digestive Surgery ( IF 2.7 ) Pub Date : 2020-11-26 , DOI: 10.1159/000511908
Toru Miyake 1 , Hiroya Iida 1 , Tomoharu Shimizu 2 , Tomoyuki Ueki 1 , Masatsugu Kojima 1 , Hiroyuki Ohta 3 , Tsuyoshi Yamaguchi 1 , Sachiko Kaida 1 , Eiji Mekata 3 , Yoshihiro Endo 4 , Masaji Tani 1
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Background: 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. Methods: 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). Results: 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%, p = 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%, p < 0.0001). TNM classification was finally identified as an independent risk factor for cancer-specific RFS in these patients by multivariate analysis. Conclusion: High preoperative PCT values in CRC patients appeared to be associated with poor OS but not RFS following surgical treatments.

中文翻译:

术前降钙素原升高与结直肠癌切除术患者预后不良有关

背景:降钙素原 (PCT) 是众所周知的细菌感染标志物;然而,PCT在结直肠癌(CRC)手术后长期预后中的临床意义仍不清楚。方法:这是一项对 277 名接受 CRC 手术的患者的回顾性研究,以研究术前 PCT、临床病理状况、癌症特异性总生存期 (OS) 和无复发生存期 (RFS) 之间的关系。结果:所有患者的中位随访间隔为 5.0 年。36 名患者出现复发,46 名患者因 CRC 复发或转移而死亡。IV期患者术前PCT水平最高。IV/PCT ≤ 0.05 ng/mL 患者的癌症特异性 OS 显着高于 IV/PCT > 0.05 ng/mL 患者(3 年生存率;42.3% vs. 14.3%,p = 0.0413)。在多变量分析中,性别、TNM 分类和 PCT 被确定为 I-III 期 CRC 患者癌症特异性 OS 的重要危险因素。与 PCT <0.08 ng/mL 相比,这些 PCT ≥ 0.08 ng/mL 患者的癌症特异性 OS 率显着降低(5 年生存率;59.1% vs. 92.7%,p < 0.0001)。通过多变量分析,TNM 分类最终被确定为这些患者癌症特异性 RFS 的独立危险因素。结论:结直肠癌患者术前高 PCT 值似乎与手术治疗后较差的 OS 而非 RFS 相关。与 PCT <0.08 ng/mL 相比,显着降低(5 年生存率;59.1 与 92.7%,p < 0.0001)。通过多变量分析,TNM 分类最终被确定为这些患者癌症特异性 RFS 的独立危险因素。结论:结直肠癌患者术前高 PCT 值似乎与手术治疗后较差的 OS 而非 RFS 相关。与 PCT <0.08 ng/mL 相比,显着降低(5 年生存率;59.1 与 92.7%,p < 0.0001)。通过多变量分析,TNM 分类最终被确定为这些患者癌症特异性 RFS 的独立危险因素。结论:结直肠癌患者术前高 PCT 值似乎与手术治疗后较差的 OS 而非 RFS 相关。
更新日期:2020-11-26
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