Preoperative Low Creatine Kinase as a Poor Prognostic Factor in Patients with Colorectal Cancer

J Gastrointest Cancer. 2024 Sep;55(3):1212-1219. doi: 10.1007/s12029-024-01069-9. Epub 2024 Jun 13.

Abstract

Purpose: This study aimed to evaluate the clinicopathological and prognostic significance of preoperative serum creatine kinase (CK) levels in colorectal cancer.

Methods: This study analyzed 1169 patients with colorectal cancer at stages 0 (n = 35), I (n = 301), II (n = 456), III (n = 339), and IV (n = 38). The CK cut-off value was 52 U/L to predict recurrence based on receiver operative characteristics curve. Clinicopathological factors were compared between the low (< 52 U/L) and high CK groups (≥ 52 U/L). The multivariate analysis evaluated relapse-free survival (RFS) and overall survival (OS) following CK status.

Results: The female sex, elderly age (≥ 75), deep tumor (pT4), and carcinoembryonic antigen (+) were independently associated with low CK status. The recurrent rate was significantly higher in the low CK group than in the high CK group (19.1% vs. 11.7%, p < 0.001). Elderly age, pT4, pN (+), preoperative carbohydrate antigen (CA) 19-9 (+), and low CK status were independent risk factors for RFS. Elderly age, pT4, pN (+), preoperative CA19-9 (+), and low CK status were independent risk factors for OS.

Conclusion: Preoperative low CK status was associated with deep tumors and was a poor prognostic factor in patients with colorectal cancer.

Keywords: Colorectal cancer; Creatine kinase; OS; RFS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor* / blood
  • Carcinoembryonic Antigen / blood
  • Colorectal Neoplasms* / blood
  • Colorectal Neoplasms* / mortality
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Creatine Kinase* / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • Risk Factors

Substances

  • Creatine Kinase
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen