Prognostic factors in advanced colorectal carcinoma: Importance of lactic dehydrogenase level, performance status, and white blood cell count

doi:10.1016/0002-9343(83)91066-5

The American Journal of Medicine

Volume 74, Issue 5, May 1983, Pages 786-794

https://doi.org/10.1016/0002-9343(83)91066-5 Get rights and content

Abstract

In 220 patients with advanced colorectal carcinoma, objective tumor response to chemotherapy and survival were related to the following parameters: age, sex, performance status, time interval from diagnosis to metastases, initial site of metastases, and initial white blood cell count, lactic dehydrogenase, alkaline phosphatase, and carcinoembryonic antigen levels. Each variable was first evaluated separately. By conventional statistical methods, none of the variables significantly predicted response, although the following parameters significantly (p < 0.01) predicted survival: Patients with an initially normal level of lactic dehydrogenase versus those with an abnormal level of lactic dehydrogenase had median survivals of 16 and 7.0 months, respectively; normal versus abnormal carcinoembryonic antigen levels, 23 and 9.2 months, respectively; white blood cell count of less than 10,000 versus greater than 10,000 cells/mm³, 11 and 7.0 months, respectively; performance status of greater than 70 versus less than 60,11 and 6.6 months, respectively; and lung versus liver metastases, 12 and 8.0 months, respectively. By studying the variables together with multivariate analysis, we found that the most important variables in predicting response were the lactic dehydrogenase level and the white blood cell count. In predicting survival, the most important variables were the lactic dehydrogenase level, performance status, and lung involvement. We recommend that future randomized therapeutic trials for advanced colorectal carcinoma should delineate and perhaps stratify for the lactic dehydrogenase level, performance status, white blood cell count, and/or the presence of lung involvement.

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^☆: This work was supported in part by National Cancer Institute grant CA-05286. Preliminary data were presented in 1981 at the American Association of Clinical Oncologists.

¹: From the Solid Tumor Service, Department of Medicine, and the Biostatistics Laboratory, Memorial Sloan-Kettering Cancer Center, New York, New York.

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Clinical studyPrognostic factors in advanced colorectal carcinoma: Importance of lactic dehydrogenase level, performance status, and white blood cell count☆

Abstract

Advanced gastrointestinal cancer—clinical management and chemotherapy

Survival and response to chemotherapy for advanced colorectal adenocarcinoma

Cancer

A randomized study of two different schedules of methyl CCNU, 5-FU and vincristine for metastatic colorectal carcinoma

Cancer

Therapy for metastatic colorectal cancer with a combination of methyl CCNU, 5-FU, vincristine and streptozotocin (MOF-strep)

Cancer

Metastatic colorectal carcinoma: a prospective randomized trial of methyl CCNU, 5-fluorouracil (5-FU) and vincristine (MOF) versus MOF plus streptozotocin (MOF-strep)

Cancer

Carcinoembryonic antigen (CEA) assay: a laboratory adjunct in the diagnosis and management of cancer

Hum Pathol

Conservatism of the approximation (O-E)2/E in the logrank test for survival data or tumor incidence data

Biometrics

Non-parametric estimation from incomplete observations

J Am Stat Assoc

A computer program for linear logistic regression analysis

Comput Programs Biomed

Regression models and life tables

J R Stat Soc Br

Serum LDH activity and isozyme patterns in nonseminomatous germinal testes tumors

Prognostic significance of serum tumor biomarkers (TM), alpha feto protein (ATP), beta subunit chorionic gonadotrophin (bHOG) and lactate dehydrogenase (LDH) in nonseminomatous germ cell tumors (NSGCT)

Clinical study
Prognostic factors in advanced colorectal carcinoma: Importance of lactic dehydrogenase level, performance status, and white blood cell count☆

Conservatism of the approximation (O-E)²/E in the logrank test for survival data or tumor incidence data