Table of Contents
ISRN Gastroenterology
Volume 2013 (2013), Article ID 490578, 6 pages
http://dx.doi.org/10.1155/2013/490578
Research Article

Factors Influencing Survival in Stage IV Colorectal Cancer: The Influence of DNA Ploidy

1Medical Oncology, Propedeutic, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, Mikras Asias 7, 11527 Athens, Greece
21st Department of Pathology, Propedeutic, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, Mikras Asias 7, 11527 Athens, Greece
32nd Department of Medical Oncology, Metaxa Cancer Hospital, Mpotasi 51, 18537 Piraeus, Greece
4Gastroenterology Unit, Department of Pathophysiology, Propedeutic, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, Mikras Asias 7, 11527 Athens, Greece
51st Department of Internal Medicine, Propedeutic, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, Mikras Asias 7, 11527 Athens, Greece

Received 17 April 2013; Accepted 12 May 2013

Academic Editors: L. David, G.-T. Huang, F. Izzo, S. Ogino, and A. K. Rishi

Copyright © 2013 Ioannis D. Xynos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To evaluate the prognostic significance of microscopically assessed DNA ploidy and other clinical and laboratory parameters in stage IV colorectal cancer (CRC). Methods. 541 patients with histologically proven stage IV CRC treated with palliative chemotherapy at our institution were included in this retrospective analysis, and 9 variables (gender, age, performance status, carcinoembryonic antigen, cancer antigen 19-9, C-Reactive Protein (CRP), anaemia, hypoalbuminaemia, and ploidy (DNA Index)) were assessed for their potential relationship to survival. Results. Mean survival time was 12.8 months (95% confidence interval (CI) 12.0–13.5). Multivariate analysis revealed that DNA indexes of 2.2–3.6 and >3.6 were associated with 2.94 and 4.98 times higher probability of death, respectively, compared to DNA index <2.2. CRP levels of >15 mg/dL and 5–15 mg/dL were associated with 2.52 and 1.72 times higher risk of death, respectively. Hazard ratios ranged from 1.29 in patients mild anaemia (Hb 12–13.5 g/dL) to 1.88 in patients with severe anaemia (Hb < 8.5 g/dL). Similarly, the presence of hypoalbuminaemia (albumin < 5 g/dL) was found to confer 1.41 times inferior survival capability. Conclusions. Our findings suggest that patients with stage IV CRC with low ploidy score and CRP levels, absent or mild anaemia, and normal albumin levels might derive greatest benefit from palliative chemotherapy.