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Preoperative Low Creatine Kinase as a Poor Prognostic Factor in Patients with Colorectal Cancer

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This study aimed to evaluate the clinicopathological and prognostic significance of preoperative serum creatine kinase (CK) levels in colorectal cancer.


This study analyzed 1169 patients with colorectal cancer at stages 0 (n = 35), I (n = 301), II (n = 456), III (n = 339), and IV (n = 38). The CK cut-off value was 52 U/L to predict recurrence based on receiver operative characteristics curve. Clinicopathological factors were compared between the low (< 52 U/L) and high CK groups (≥ 52 U/L). The multivariate analysis evaluated relapse-free survival (RFS) and overall survival (OS) following CK status.


The female sex, elderly age (≥ 75), deep tumor (pT4), and carcinoembryonic antigen (+) were independently associated with low CK status. The recurrent rate was significantly higher in the low CK group than in the high CK group (19.1% vs. 11.7%, p < 0.001). Elderly age, pT4, pN (+), preoperative carbohydrate antigen (CA) 19-9 (+), and low CK status were independent risk factors for RFS. Elderly age, pT4, pN (+), preoperative CA19-9 (+), and low CK status were independent risk factors for OS.


Preoperative low CK status was associated with deep tumors and was a poor prognostic factor in patients with colorectal cancer.

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Data Availability

No datasets were generated or analysed during the current study.



Creatine kinase


Carcinoembryonic antigen


Carbohydrate antigen 19-9


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We thank Seiko Otsuka (Toho University) for preparing the ethical documents. Additionally, we would like to thank MARUZEN-YUSHODO Co., Ltd. ( for the English language editing.


No funding was received for this work.

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Authors and Affiliations



MU, HS, and K conceived and designed the current study. MU, TK, YM, KY, TS, SK, and AK contributed to the acquisition of the patient’s clinicopathological data. MU and HSH analyzed the patient data. MU and HS drafted the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hideaki Shimada.

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Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Toho University Omori Medical Center (#M21320 21039 20200 30196 19056 18002).

Consent to Participate

The participants were given the opportunity to decline to be enrolled in the study (opt-out).

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The authors declare no competing interests.

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Ushigome, M., Shimada, H., Kaneko, T. et al. Preoperative Low Creatine Kinase as a Poor Prognostic Factor in Patients with Colorectal Cancer. J Gastrointest Canc (2024).

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