PROGNOSTIC VARIABLES IN PATIENTS WITH ADVANCED COLORECTAL-CANCER TREATED WITH FLUOROURACIL AND LEUCOVORIN-BASED CHEMOTHERAPY

Possible prognostic variables for tumor response, time to progression (TTP), and survival in 141 patients with advanced colorectal cancer tr eated with fluorouracil acid leucovorin-based chemotherapy were analyz ed. None of the Variables examined for their possible influence on tum or response attained significance in the stepwise logistic regression. In the univariate analysis, variables found to be strongly associated with TTP were performance status (PS) (P = 0.0301), liver involvement (P = 0.030), and the initial values of WBC (P = 0.0319), lactic dehyd rogenase (LDH; P = 0.0053), gamma-glutamyl-transpeptidase (gamma-GT; P = 0.0013), alkaline phosphatase (ALP; P = 0.0186), albumin (P = 0.000 4), and carcinoembryonic antigen (CEA; P = 0.0014). In the Cox analysi s, liver involvement (P = 0.0553), albumin (P = 0.0181), PS (P = 0.048 4),and ALP (P = 0.0553) were retained as independently significant var iables. When only patients with liver metastases were included in the analysis, then only albumin (P < 0.001) demonstrated a prognostic sign ificance. Also, in the univariate analysis, variables predicting survi val were PS (P = 0.0230), grade (P = 0.0060), liver involvement (P = 0 .0002), LDH (P = 0.0001), gamma-GT (P < 0.001), ALP (P = 0.0006), albu min (P = 0.0309), and CEA (P = 0.0005). With the multivariate analysis , gamma-GT (P = 0.0004), albumin (P = 0.0634), and CEA (P = 0.0804) we re selected as significant. in those patients who presented with liver involvement, variables predicted survival were gamma-GT (P = 0.0041), albumin (P = 0.0442), and the percentage of involved liver parenchyma (P = 0.0690). These results could be helpful for the stratification o f future trials in advanced colorectal cancer. (C) 1996 Wiley-Liss, In c.