Prognostic factors in colorectal cancer patients treated with first line oxaliplatin/5-fluorouracil combination

Aim: We analysed the different variables, which may potentially influence the median survival of advanced CRC patients.

Methods: 42 advanced CRC patients were treated in first line setting according to Folfox4 regimen (85mg/m2 oxaliplatin on Day1, 200mg/m2 leucovorin bolus, 400mg/m2 5-fluorouracil bolus, 600mg/m2 5-fluorouracil as 22 hour continuos infusion on Day1–2) at our department between January 2003 and November 2003. All patients received second line irinotecan containing treatment. The analysed factors at the initiation of treatment were haematological parameters (WBC, RBC, PLT), CEA and ALP level, and the number of metastically involved organs.

Results: The median survival (MS) of the 42 pts. was 19.09 months at the time point of data analysis, 4 patients being still alive. The MS of patients with baseline WBC>10×109/l was 16.29 mths (9 pts) vs. 19.34 mths WBC<10×109/l (33 pts). 15 patients with PLT>400×109/l showed 15.83 mths survival vs. 19.49 mths PLT<400×109/l. 20 anaemic (Hb<12g/l) patients' survival was 17.1 compared with 19.5 mths with 22 normally oxygenised pts. The 20 patients with CEA level within 3-fold of ULN presented 17.55 mths MS vs.19.11 mths of those 18 above the settled range. 20 patients with normal ALP levels showed 17.95 mths OS vs. 18.76 mths in the elevated ALP group of 22 pts.. Pts. with more than one metastically involved organs (17) presented 14.4 mths MS vs. 21.72 mths in the 25 single organ affected pts.

Conclusion: In our analysed pool of patients the ALP level showed no predictive value. The WBC, PLT count and baseline HB value, and outstandingly the number of metastatically involved organs may influence the long term outcome of advanced CRC pts. treated with main stream chemotherapeutic regimens.