title: Significance of postoperative adjuvant immunochemotherapy after curative resection of colorectal cancers: Association between host or tumor factors and survival.
abstract: We examined the relationship between host as well as tumor factors and postoperative survival rate in patients who received combination therapy of mitomycin C + fluoropyrimidine oral antineoplastics + protein-bound polysaccharide K (PSK) (MFP therapy) after curative resection of colorectal cancer. Markers that determine prognosis, such as preoperative humoral factors (complement 3 and 4), immunosuppressive acidic protein (IAP), lymphocyte transformation (cellular factors) induced by phytohemagglutinin (PHA), pokeweed mitogen (PWM), and PSK, and various tumor markers (CEA, CA19-9) were measured. For each parameter, patients were divided into a high-level and a low-level group according to a predetermined cut-off value, and survival rates were compared between the two groups. The host factors that determined prognosis were 1-month postoperative IAP level [IAP(1M)], preoperative PHA value, and preoperative CA19-9 level. The levels of IAP(1M) <740 microg/ml, preoperative PHA > or =210 (SI value), and preoperative CA19-9 <13 U/ml were associated with a favorable prognosis. When combined with the tumor factors, the prognosis was favorable in Dukes A+B cases with preoperative CA19-9 <13 U/ml, and in Dukes C cases with preoperative PHA > or =210 SI. By the Cox proportional hazard model analysis, among IAP, PHA and CA19-9, CA19-9 was the strongest host factor associated with the prognosis of MFP therapy.
authors.affiliation: Department of Surgery, Prefecture of Saiseikai Fukui Hospital, Fukui 918-8503, Japan. y-munemoto@fukui.saiseikai.or.jp
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Munemoto
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Iida
authors.forename: Jinro
authors.initials: J
authors.lastname: Abe
authors.forename: Hideo
authors.initials: H
authors.lastname: Saito
authors.forename: Katsunori
authors.initials: K
authors.lastname: Fujisawa
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Kasahara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Mitsui
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Asada
authors.forename: Shouji
authors.initials: S
authors.lastname: Miura
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D003176:Complement C3 / Q000378:metabolism; D003181:Complement C4 / Q000378:metabolism; D005260:Female; D006801:Humans; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use; D009363:Neoplasm Proteins / Q000378:metabolism; D010835:Phytohemagglutinins / Q000494:pharmacology; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use; D011184:Postoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D003176:Complement C3; D003181:Complement C4; D009363:Neoplasm Proteins; D010835:Phytohemagglutinins; D011134:Polysaccharides; D011743:Pyrimidines; C030193:immunosuppressive acidic protein; D016685:Mitomycin; C029269:5-fluoropyrimidine