PROGNOSTIC PREDICTORS IN COLORECTAL-CANCER

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.