Lead time and prognostic role of serum cea, ca19-9, il-6, crp, and ykl-40 after adjuvant chemotherapy in colorectal cancer

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In colorectal cancer (CRC), 20–50% of patients relapse after curative-intent surgery with or without adjuvant therapy. We investigated the lead times and prognostic value of post-adjuvant (8 months from randomisation to adjuvant treatment) serum CEA, CA19-9, IL-6, CRP, and YKL-40. We included 147 radically resected stage II–IV CRC treated with 24 weeks of adjuvant 5-fluorouracilbased chemotherapy in the phase III LIPSYT-study (ISRCTN98405441). All 147 were included in lead time analysis, but 12 relapsing during adjuvant therapy were excluded from post-adjuvant analysis. Elevated post-adjuvant CEA, IL-6, and CRP were associated with impaired disease-free survival (DFS) with hazard ratio (HR) 5.21 (95% confidence interval 2.32–11.69); 3.72 (1.99–6.95); 2.58 (1.18–5.61), respectively, and elevated IL-6 and CRP with impaired overall survival (OS) HR 3.06 (1.64–5.73); 3.41 (1.55–7.49), respectively. Elevated post-adjuvant IL-6 in CEA-normal patients identified a subgroup with impaired DFS. HR 3.12 (1.38–7.04) and OS, HR 3.20 (1.39–7.37). The lead times between the elevated biomarker and radiological relapse were 7.8 months for CEA and 10.0–53.1 months for CA19-9, IL-6, CRP, and YKL-40, and the lead time for the five combined was 27.3 months. Elevated post-adjuvant CEA, IL-6, and CRP were associated with impaired DFS. The lead time was shortest for CEA.

OriginalsprogEngelsk
Artikelnummer3892
TidsskriftCancers
Vol/bind13
Udgave nummer15
Antal sider16
ISSN2072-6694
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
This investigator-initiated study was supported by Finska L?kares?llskapet, The Finnish Cancer Foundation, The Competitive State Research Financing of the Expert Responsibility Area of Tampere and Helsinki, Tampere University Hospital Support Foundation (Tukis??ti? and OOO-project), and Relander?s Foundation. The funders had no role in the study design; conduct of the study; collection, analysis, and interpretation of the data; or the writing of this report.

Funding Information:
Funding: This investigator-initiated study was supported by Finska Läkaresällskapet, The Finnish Cancer Foundation, The Competitive State Research Financing of the Expert Responsibility Area of Tampere and Helsinki, Tampere University Hospital Support Foundation (Tukisäätiö and OOO-project), and Relander’s Foundation. The funders had no role in the study design; conduct of the study; collection, analysis, and interpretation of the data; or the writing of this report.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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