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Abstract
Limited studies have assessed the associations of pretreatment serum glutamine level with clinicopathological characteristics and prognosis of colorectal cancer (CRC) patients. This study focuses on clarifying the clinical significance of baseline serum glutamine level in CRC patients. We retrospectively examine 123 patients with newly diagnosed CRC between 2009 and 2011. The associations of pretreatment serum glutamine level with clinicopathological characteristics, proinflammatory cytokines, overall survival (OS), and progression-free survival (PFS) were analyzed. We executed univariate and multivariate analyses to assess the associations between serum glutamine level and clinicopathological variables able to predict survival. Low glutamine levels were associated with older age, advanced stage, decreased albumin levels, elevated carcinoembryonic antigen levels, higher C-reactive protein levels, higher modified Glasgow prognostic scores, and higher proinflammatory cytokine levels. Furthermore, patients with low glutamine levels had poorer OS and PFS than those with high glutamine levels (p < 0.001 for both). In multivariate analysis, pretreatment glutamine level independently predicted OS (p = 0.016) and PFS (p = 0.037) in CRC patients. Pretreatment serum glutamine level constitutes an independent prognostic marker to predict survival and progression in CRC patients.
Highlights
Colorectal cancer (CRC) is a prevalent and common cause of cancer deaths worldwide, with832,000 deaths in 2015 [1,2]
Considering the heterogeneity of body mass index (BMI) among geographic regions and ethnicities, we categorized the patients into four groups according to the BMI classification of Department of Health in Taiwan, which consisted of underweight (BMI < 18.5 kg/m2 ), normal (18.5 to 23.9 kg/m2 ), overweight (24 to 26.9 kg/m2 ) and obese (≥27 kg/m2 ) groups [27]. 14 (11.4%) patients were underweight, 61 (49.6%) patients had a normal BMI, 31 (25.2%) patients were overweight, and 17 (13.8%) patients were obese
Revealed low serum glutamine levels were associated with poor cancer-specific survival and overall survival (OS) in univariate analysis, but no prognostic significance of glutamine levels was observed in multivariate analysis
Summary
Colorectal cancer (CRC) is a prevalent and common cause of cancer deaths worldwide, with. 832,000 deaths in 2015 [1,2]. Curative surgery remains the best chance of cure in CRC patients, while systemic targeted therapy and chemotherapy are the standards of care for disease recurrence or metastasis. Some patients still have early progression and dismal outcome [3]. The widely accepted prognostic factors for survival in CRC patients include tumor-node-metastasis (TNM) staging, histologic grade, tumor location, and carcinoembryonic antigen (CEA) level [4,5,6]. Individual CRC patients demonstrate different survival times and recurrence.
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