Tumor Biology

, Volume 36, Issue 10, pp 7897–7906 | Cite as

Preoperative serum markers for individual patient prognosis in stage I–III colon cancer

  • Clemens Giessen-Jung
  • Dorothea Nagel
  • Maria Glas
  • Fritz Spelsberg
  • Ulla Lau-Werner
  • Dominik Paul Modest
  • Christoph Schulz
  • Volker Heinemann
  • Dorit Di Gioia
  • Petra Stieber
Research Article

Abstract

Carcinoembryonic antigen (CEA) remains the only recommended biomarker for follow-up care of colorectal cancer (CRC), but besides CEA, several other serological parameters have been proposed as prognostic markers for CRC. The present retrospective analysis investigates a comprehensive set of serum markers with regard to cancer-specific survival (CSS) and disease-free survival (DFS). A total of 472 patients with colon cancer underwent surgery for curative intent between January 1988 and June 2007. Preoperative serum was analyzed for the following parameters: albumin, alkaline phosphatase (aP), beta-human chorionic gonadotropin (βhCG), bilirubin, cancer antigen 125 (CA 125), cancer antigen 19-9 (CA 19-9), CA 72-4, CEA, C-reactive protein (CRP), cytokeratin-19 soluble fragment (CYFRA 21-1), ferritin, gamma-glutamyltransferase (γGT), glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), hemoglobin, haptoglobin, interleukin-6, interleukin-8, creatinine, lactate dehydrogenase (LDH), serum amyloid A (SAA), and 25-hydroxyvitamin D. After a median follow-up period of 5.9 years, the overall 3- and 5-year CSS was 91.7 and 84.9 % and DFS rates were 82.7 % (3 years) and 77.6 % (5 years). Multivariate analyses confirmed preoperative CEA as an independent prognostic factor with regard to CSS and DFS. CA 19-9 and γGT also provided prognostic value for CSS and DFS, respectively. Younger age was negatively associated with DFS. According to UICC stage, CEA provided significant prognostic value with regard to CSS and DFS, while CA 19-9 was only prognostic for CSS. Combined analysis is able to identify patients with favorable prognosis. In addition to tumor baseline parameters, preoperative CEA could be confirmed as prognostic marker in colon cancer. CA 19-9 and γGT also provide additional prognostic value with regard to survival and recurrence in stage III and stage I disease, respectively. The combined use of CEA together with CA 19-9 and γGT improve risk-adapted post-op surveillance.

Keywords

Colorectal cancer Tumor marker CEA CA 19-9 Gamma-glutamyltransferase Prognostic factors 

Notes

Acknowledgments

The authors thank Matthias Wolff for expert secretarial assistance. No direct or indirect funding was received for this study.

Conflicts of interest

None

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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Clemens Giessen-Jung
    • 1
  • Dorothea Nagel
    • 2
  • Maria Glas
    • 1
  • Fritz Spelsberg
    • 3
  • Ulla Lau-Werner
    • 3
  • Dominik Paul Modest
    • 1
  • Christoph Schulz
    • 1
  • Volker Heinemann
    • 1
  • Dorit Di Gioia
    • 1
  • Petra Stieber
    • 2
  1. 1.Department of Medical Oncology, Klinikum Grosshadern and Comprehensive Cancer CenterUniversity of MunichMunichGermany
  2. 2.Institute of Laboratory Medicine, Klinikum GrosshadernUniversity of MunichMunichGermany
  3. 3.Department of Surgery, Klinikum GrosshadernUniversity of MunichMunichGermany

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