PURPOSE: Better prognostic predictors in colorectal cancer than the Du
kes stage are necessary for individualized therapy and follow-up. METH
ODS: Survival among 212 patients operated on for colorectal cancer was
examined regarding various clinical, histopathologic, cellular, and s
erologic tumor characteristics. RESULTS: Beside the Dukes stage, which
was the most powerful variable, the erythrocyte sedimentation rate, l
eukocyte blood count, alkaline phosphatase, aspartate aminotransferase
, six different serum tumor markers, number of small blood vessels, an
d age were found to be significantly associated with survival. The leu
kocyte blood count, alkaline phosphatase, and aspartate aminotransfera
se retained their significance in a multivariate model including tumor
differentiation, local tumor stage, and age. Inclusion of tissue poly
peptide antigen, the most powerful tumor marker in the multivariate mo
del, showed that only the tumor stage, tissue polypeptide antigen, and
age were statistically significantly correlated to survival. This was
valid both for the group of patients considered as potentially curabl
e and for those who potentially have been cured (Dukes Stages A-C). CO
NCLUSIONS: A great number of prognostic predictors failed to discard D
ukes stage as the best one. One serum tumor marker, tissue polypeptide
antigen, contains independent additional prognostic information.