The association between neutropenia and prognosis in stage III colorectal cancer patients receiving adjuvant chemotherapy

Abstract

Neutropenia during chemotherapy has been reported to be a predictor of better survival in patients with several types of cancer, although there are no reports on stage III colorectal cancer (CRC). The purpose of this study was to examine the association between neutropenia and prognosis in stage III CRC patients receiving adjuvant chemotherapy consisting of oral uracil and tegafur (UFT) plus leucovorin (LV). We retrospectively analysed 123 patients with stage III CRC who received UFT/LV as adjuvant chemotherapy. The end-point was disease-free survival (DFS). Survival curves of the two categories (neutropenia absent vs. present) were estimated using the Kaplan-Meier method and compared by the log-rank test. We estimated the hazard ratio (HR) for DFS according to neutropenia after adjustment for covariates by multivariate analyses using Cox's regression analysis. A total of 33 (26.8%) patients experienced neutropenia. Patients without neutropenia showed a significantly lower DFS than those with neutropenia (3-year DFS 57.3% vs. 81.2%, P = 0.0213). By multivariate analysis, neutropenia and histological type were independent prognostic factors, with HR of 0.410 (neutropenia absent vs. present, P = 0.045) and 4.793 (well to moderately differentiated vs. poorly differentiated, P = 0.004) respectively. We demonstrated that neutropenia occurring during adjuvant chemotherapy consisting of UFT/LV may be a prognostic factor of recurrence in stage III CRC patients.

Chemotherapy-induced neutropenia as a prognostic factor in patients with unresectable pancreatic cancer

“…Similarly, it has been suggested that neutropenia is associated with good prognosis in first-line treatment for other types of cancers [15][16][17][18][19][20][21][22][23][24][25]. In addition, in the present study, all patients in the first-line treatment group exhibited prolonged OS for grades 1-3, with particularly good survival for grades 2 and 3.…”

“…In this study, grade of neutropenia has been using nadir during all GEM courses similar to the methodology of other studies [17][18][19][20][21][22][23]. Among the 99 subjects who experienced neutropenia in the first-line population, 71 patients (72 %) have reached the nadir in neutropenia of first course, and 89 (90 %) patients have reached the nadir until the second course.…”

“…Subsequent reports described similar outcomes for nonsmall cell lung cancer [17][18][19], gastric cancer [20], colorectal cancer [21,22], and ovarian cancer [19,23]. These reports suggest that neutropenia could be a predictive factor of treatment responsiveness.…”

The maximum chemiluminescence intensity predicts severe neutropenia in gemcitabine-treated patients with pancreatic or biliary tract cancer

“…SN is associated with the long-term prognosis of patients with various types of cancer, including breast [ 31 , 32 ], small cell lung [ 33 , 34 ], gastric [ 35 ], colorectal [ 36 , 37 ], ovarian [ 38 ], and pancreatic [ 39 , 40 ]. The long-term prognosis may be associated with SN and CI max , though this was not evaluated in this study.…”

Adherence, Dosing, and Managing Toxicities With Trifluridine/Tipiracil (TAS-102)

“…12–15 A post-hoc analysis of RECOURSE was performed to determine the potential correlation between onset of Grade ≥3 neutropenia and clinical benefit. 16 Of 533 patients who received trifluridine/tipiracil, 75 (14%) developed Grade ≥3 neutropenia in treatment cycle 1, 86 (16%) in cycle 2, and 39 (7%) in cycle ≥3.…”