Abstract
as 180 with colonic and 117 with rectal cancer. The median observation period was 6.1 (5.2-7.3) years and 162 deaths were recorded. In a multivariate analysis including age, gender, stage, localization, plasma TIMP-1 and CEA it was shown that plasma TIMP-1 had independent, significant prognostic value: HR = 2.9; 95% CI: 2.0-4.8; p<0.0001, whereas the value of CEA was non-significant. Restricting the analysis to stages II and III and patients not receiving adjuvant chemotherapy plasma TIMP-1 had independent, significant prognostic value: HR = 2.9; 95% CI: 1.3-6.8; p=0.013, whereas the value of CEA was non-significant. Analysis including those patients, who received adjuvant chemotherapy, showed that neither plasma TIMP-1 nor CEA had any prognostic value. This indicates that adjuvant chemotherapy may be efficient to patients with high plasma TIMP-1 levels. Similar analysis of patients with stages II and III and focus on DFS as the endpoint could not demonstrate significant results. Conclusion: The present results achieved in a prospective study confirm that preoperative plasma TIMP-1 has independent prognostic value. In addition, the results suggest that patients with stage II or III and high plasma TIMP-1 values have particular benefit of adjuvant chemotherapy. The results must however be confirmed in prospective studies with inclusion of sufficient numbers of patients to confirm the results.
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