Prognosis of colorectal cancer patients with elevated endothelin-1 concentrations.
OBJECTIVE
Prognostic indicators from clinical, laboratory and pathological data of patients with colorectal cancer are essential to identify high-risk groups in whom adjuvant therapy could be beneficial. Endothelin-1 (ET-1), a growth factor, has been associated with the development and spread fo solid tumours. This prospective study was performed to determine whiter preoperative plasma big ET-1 concentrations might be useful as a prognostic indicator in patients with colorectal carcinoma.


METHODS
Overall, 65 consecutive patients with colorectal cancer confirmed by biopsy were include prospectively in this study from 1998 to 2001. Plasma samples from a peripheral vein were obtained prior to surgery. Univariant analysis of survival used age (less than or more than 70 years), gender, Dukes' stage (A/B vs C), tumour size (less than or more than 50 mm), vascular invasion, and plasma big ET-1 concentrations, and significant factors were then analysed using a Cox regression model.


RESULTS
Three variables, age, Dukes' tumour stage and plasma big ET-1 concentration, and prognostic significance (p < 0.05). Factors associated with a poorer prognosis were age more than 70 years (p = 0.02), Dukes' C (p = 0.04) and plasma big ET-1 concentration more than 4.2 pg/mL (p = 0.02). The Cox regression model identified the same three variables as having independent prognostic value for overall survival.


CONCLUSIONS
Preoperative plasma big ET-1 concentration may be useful in predicting overall survival in patients with colorectal cancer. Plasma big ET-1 concentrations may be useful in the selection of high-risk, lymph node-negative patients with colorectal cancer for adjuvant therapy.
Elahi
Maqsood M
MM
Department of General and Gastrointestinal Surgery, Leicster Royal Infirmery, LE5 PW, UK. manzoor_elahi@hotmail.com
Everson
Noel W
NW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate
D019332:Endothelin-1