Vitamin antioxidants, lipid peroxidation, tumour stage, the systemic inflammatory response and survival in patients with colorectal cancer

• Published in: International journal of cancer Vol. 123; no. 10; pp. 2460 - 2464
• Main Authors: Leung, Elaine Y.L., Crozier, Joseph E.M., Talwar, Dinesh, O'Reilly, Denis St. J., McKee, Ruth F., Horgan, Paul G., McMillan, Donald C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15-11-2008; Wiley-Liss
• Subjects: Aged; Antioxidants - metabolism; Biological and medical sciences; carotenoids; colorectal cancer; Colorectal Neoplasms - metabolism; Colorectal Neoplasms - pathology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Glasgow prognostic score; Humans; Inflammation - metabolism; Liver Neoplasms - secondary; Male; malonyldialdehyde; Medical sciences; Middle Aged; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival; TNM stage; Tumors; vitamin A; vitamin E; Vitamins - metabolism; Glasgow prognostic score; Rectal disease; Prognosis; TNM stage; carotenoids; Colorectal cancer; Lipids; Cancerology; Vitamin E; Intestinal disease; Peroxidation; Human; malonyldialdehyde; vitamin A; Inflammation; Malignant tumor; Antioxidant; Survival; TNM-System; Retinol; Colonic disease; Clinical stage; Digestive diseases; Carotenoid; Cancer
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.23811

Both the tumour growth and progression and the systemic inflammatory response have the potential to increase oxidative stress. We therefore examined the relationship between lipid‐soluble antioxidant vitamins, lipid peroxidation, the systemic inflammatory response and survival in patients with primary operable (n = 53) and advanced inoperable (n = 53) colorectal cancer. Compared with those patients with primary operable colorectal cancer, patients with unresectable liver disease had significantly lower median concentrations of α‐tocopherol (p < 0.001), lutein (p < 0.001), lycopene (p < 0.001), α‐carotene (p < 0.01) and β‐carotene (p < 0.001) and higher malondialdehyde concentrations. An elevated systemic inflammatory response (Glasgow prognostic score, mGPS) was associated with a greater proportion of females (p < 0.05) and more advanced tumour stage (p < 0.05), lower circulating levels of retinol (p < 0.01), lutein (p < 0.01), lycopene (p < 0.01) and α‐ (p < 0.01) and β‐carotene but not MDA (p = 0.633). In the liver metastases group 41 patients died of their cancer and a further 1 patient died of intercurrent disease on follow‐up. On univariate survival analysis, mGPS (p < 0.01), retinol (p < 0.001), α‐tocopherol (p < 0.05) and α‐carotene (p < 0.05) were associated significantly with cancer‐specific survival. On multivariate survival analysis of these significant variables, only mGPS (p < 0.01) and retinol (p < 0.001) were independently associated with cancer‐specific survival. The results of the present study showed that the systemic inflammatory response was associated with a reduction of lipid‐soluble antioxidant vitamins, whereas advanced tumour stage was associated with increased lipid peroxidation in patients with colorectal cancer. Of the antioxidant vitamins measured, only retinol was independently associated with cancer‐specific survival. © 2008 Wiley‐Liss, Inc.