Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2024; 16(6): 2429-2438
Published online Jun 15, 2024. doi: 10.4251/wjgo.v16.i6.2429
Predictive value of preoperative routine examination for the prognosis of patients with pT2N0M0 or pT3N0M0 colorectal cancer
Peng-Fei Jing, Jin Chen, En-Da Yu, Chao-Yu Miao
Peng-Fei Jing, En-Da Yu, Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai 200433, China
Jin Chen, Department of Endocrinology and Metabolism, Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai 200433, China
Chao-Yu Miao, Department of Pharmacology, Second Military Medical University/Naval Medical University, Shanghai 200433, China
Co-corresponding authors: En-Da Yu and Chao-Yu Miao.
Author contributions: Yu ED and Miao CY performed study concept and design, revised the manuscript and made final approval of the version; Jing PF participated in collection and assembly of data; Jing PF and Chen J analyzed data and wrote the manuscript; and all authors read and approved the final paper.
Institutional review board statement: Our study complies with all ethical regulations of the Changhai Hospital Ethics Committee, and granted the ethical number: CHEC2023-125.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this paper, and further inquiries can be directed to the corresponding author (endayuchanghai@smmu.edu.cn).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao-Yu Miao, Professor, Department of Pharmacology, Second Military Medical University/Naval Medical University, No. 325 Guohe Road, Shanghai 200433, China. cymiao@smmu.edu.cn
Received: November 24, 2023
Revised: March 3, 2024
Accepted: April 9, 2024
Published online: June 15, 2024
Processing time: 203 Days and 16.8 Hours
Abstract
BACKGROUND

In recent years, the incidence of colorectal cancer (CRC) has been increasing. With the popularization of endoscopic technology, a number of early CRC has been diagnosed. However, despite current treatment methods, some patients with early CRC still experience postoperative recurrence and metastasis.

AIM

To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.

METHODS

A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study. Results of blood routine test, liver and kidney function tests and tumor markers were collected before surgery. Patients were followed up through disease-specific database and telephone interviews. Tumor recurrence, metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.

RESULTS

We comprehensively compared the predictive value of preoperative blood routine, blood biochemistry and tumor markers for disease-free survival (DFS) and overall survival (OS) of CRC. Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS [hazard ratio (HR) = 0.995, 95% confidence interval (CI): 0.991-0.999, P = 0.015], while serum carcinoembryonic antigen (CEA) level (HR = 1.008, 95%CI: 1.001-1.016, P = 0.027) and serum total cholesterol level (HR = 1.538, 95%CI: 1.026-2.305, P = 0.037) were independent risk factors for OS. The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL. Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level, the difference between the two groups was not statistically significant (P = 0.075).

CONCLUSION

For patients with T2N0M0 or T3N0M0 CRC, preoperative platelet count was a protective factor for DFS, while serum CEA level was an independent risk factor for OS. Given that these measures are easier to detect and more acceptable to patients, they may have broader applications.

Keywords: Colorectal cancer; Platelet count; Serum carcinoembryonic antigen; Total cholesterol level; Overall survival; Disease-free survival

Core Tip: By analyzing the results of preoperative blood tests for pT2N0M0/pT3N0M0, we found that preoperative platelet count was a protective factor for disease-free survival, while serum carcinoembryonic antigen level was an independent risk factor for overall survival. Given that these measures are easier to detect and more widely available, they may have a broader application in the future.