Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer
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 ra...
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MDPI AG
2021-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/15/3892 |
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| author | Kaisa Lehtomäki Harri Mustonen Pirkko-Liisa Kellokumpu-Lehtinen Heikki Joensuu Kethe Hermunen Leena-Maija Soveri Mogens Karsbøl Boisen Christian Dehlendorff Julia Sidenius Johansen Caj Haglund Pia Osterlund |
| author_facet | Kaisa Lehtomäki Harri Mustonen Pirkko-Liisa Kellokumpu-Lehtinen Heikki Joensuu Kethe Hermunen Leena-Maija Soveri Mogens Karsbøl Boisen Christian Dehlendorff Julia Sidenius Johansen Caj Haglund Pia Osterlund |
| author_sort | Kaisa Lehtomäki |
| collection | DOAJ |
| description | 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-fluorouracil-based 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. |
| first_indexed | 2024-03-10T09:17:22Z |
| format | Article |
| id | doaj.art-e0b781ab1fef49cda37226febff59600 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T09:17:22Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e0b781ab1fef49cda37226febff596002023-11-22T05:29:40ZengMDPI AGCancers2072-66942021-08-011315389210.3390/cancers13153892Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal CancerKaisa Lehtomäki0Harri Mustonen1Pirkko-Liisa Kellokumpu-Lehtinen2Heikki Joensuu3Kethe Hermunen4Leena-Maija Soveri5Mogens Karsbøl Boisen6Christian Dehlendorff7Julia Sidenius Johansen8Caj Haglund9Pia Osterlund10Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, FinlandDepartment of Gastrointestinal Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 440, 00029 HUS Helsinki, FinlandFaculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, FinlandDepartment of Oncology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, 00290 Helsinki, FinlandDepartment of Gastrointestinal Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 440, 00029 HUS Helsinki, FinlandHyvinkää Hospital and Hyvinkää Homecare, Sairaalankatu 1, 05850 Hyvinkää, FinlandDepartment of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls vej 1, DK-2730 Herlev, DenmarkStatistics and Data Analysis Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, DK-2100 Copenhagen, DenmarkDepartment of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls vej 1, DK-2730 Herlev, DenmarkDepartment of Gastrointestinal Surgery, Helsinki University Hospital and University of Helsinki, P.O. Box 440, 00029 HUS Helsinki, FinlandFaculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520 Tampere, FinlandIn 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-fluorouracil-based 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.https://www.mdpi.com/2072-6694/13/15/3892colorectal cancerprognostic biomarkertumour markerCEACA19-9IL-6 |
| spellingShingle | Kaisa Lehtomäki Harri Mustonen Pirkko-Liisa Kellokumpu-Lehtinen Heikki Joensuu Kethe Hermunen Leena-Maija Soveri Mogens Karsbøl Boisen Christian Dehlendorff Julia Sidenius Johansen Caj Haglund Pia Osterlund Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer Cancers colorectal cancer prognostic biomarker tumour marker CEA CA19-9 IL-6 |
| title | Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer |
| title_full | Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer |
| title_fullStr | Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer |
| title_full_unstemmed | Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer |
| title_short | Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer |
| title_sort | lead time and prognostic role of serum cea ca19 9 il 6 crp and ykl 40 after adjuvant chemotherapy in colorectal cancer |
| topic | colorectal cancer prognostic biomarker tumour marker CEA CA19-9 IL-6 |
| url | https://www.mdpi.com/2072-6694/13/15/3892 |
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