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The role of post-operative glutamine serum level and one-year survival rate of stage III of colorectal cancer patients: a single center study

  • Muhamad Muamar ,
  • Ida Bagus Budhi ,
  • Widyanti Soewoto ,
  • Nunik Agustriani ,
  • Darmawan Ismail ,

Abstract

Introduction: Colorectal cancer (CRC) occurs, accounting for 11.5% of all patients with cancer in Indonesia. The less the spread of cancer, the higher the life expectancy of patients with cancer. Glutamine is involved in tumor cell proliferation and growth. This study aims to verify the correlation of serum glutamine levels with the one-year survival rate of patients with stadium III colorectal cancer at Dr. Moewardi Hospital, Surakarta, Indonesia.

Method: A quantitative analytic-observational longitudinal study (Cohort) was conducted from May 1st, 2020, to September 30th, 2021. Inclusion criteria were the CRC patients with stage III and could be followed up for one year. Exclusion criteria were the CRC patients who had other systemic problems. The patient’s blood glutamine levels were taken three months postoperatively measured by Glutamine Assay kit (Colorimetric) ab197011 and evaluated clinically for one year. Glutamine levels in the blood are low if they are less than 52 ng/µL. The parameters assessed were glutamine serum level and survival rate of colorectal cancer patients. Statistical analysis using the Chi-square test and the Kaplan Meier method was employed to obtain the survival curve. Analysis to compare survival rate with glutamine levels used the Cox regression model.

Results: A one-year survival rate in patients with stadium III colorectal cancer was 95.5% at post-operative glutamine levels of ≥ 52 ng/µL and 65.4% at post-operative glutamine levels of < 52 ng/µL. The mean progressive free survival rate was 11.818 months (95%CI=11.470-12.166) at post-operative glutamine levels of ≥ 52 ng/µL and 10.038 months (95%CI=8.913-11.164) at post-operative glutamine levels of < 52 ng/µL. The overall free survival rate was 11.955 months (95%CI=11.868-12.042) at post-operative glutamine levels of ≥ 52 ng/µL and 10.885 months (95% CI=10.128-11.641) at post-operative glutamine levels of < 52 ng/µL. Patients with glutamine levels of <52 ng/µL were 8.959 times more probable to die than patients with post-operative glutamine levels of ≥ 52 ng/µL.

Conclusion: This study shows a significant relationship between serum glutamine levels and the one-year survival rate of patients with stadium III colorectal cancer at Dr. Moewardi Hospital, Surakarta, Indonesia.

References

  1. American Cancer Society. Colorectal Cancer Facts & Figures 2020-2022. Atlanta: American Cancer Society. 2020.
  2. White A, Ironmonger L, Steele RJC, Ormiston-Smith N, Crawford C, Seims A. A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK. BMC Cancer. 2018;18(1):906. doi:10.1186/s12885-018-4786-7.
  3. Vatandoost N, Ghanbari J, Mojaver M, et al. Early detection of colorectal cancer: from conventional methods to novel biomarkers. J Cancer Res Clin Oncol. 2016;142(2):341-351. doi:10.1007/s00432-015-1928-z.
  4. Hao Y, Samuels Y, Li Q, et al. Oncogenic PIK3CA mutations reprogram glutamine metabolism in colorectal cancer. Nat Commun. 2016;7:11971. doi:10.1038/ncomms11971.
  5. Budhi IB. Resectable Gastric Adenocarcinoma Cancer and the Role of Early Feeding on Clinical Outcome. OAMJMS. 2022;10(B). p. 707–709. doi: 10.3889/oamjms.2022.8782.
  6. Wong MCS, Huang J, Lok V, et al. Differences in Incidence and Mortality Trends of Colorectal Cancer Worldwide Based on Sex, Age, and Anatomic Location. Clin Gastroenterol Hepatol. 2021;19(5):955-966.e61. doi:10.1016/j.cgh.2020.02.026.
  7. Siegel RL, Torre LA, Soerjomataram I, et al. Global patterns and trends in colorectal cancer incidence in young adults. Gut. 2019;68(12):2179-2185. doi:10.1136/gutjnl-2019-319511.
  8. Hanyuda A, Cao Y, Hamada T, et al. Body mass index and risk of colorectal carcinoma subtypes classified by tumor differentiation status. Eur J Epidemiol. 2017;32(5):393-407. doi:10.1007/s10654-017-0254-y.
  9. Meyerhardt JA, Kroenke CH, Prado CM, et al. Association of Weight Change after Colorectal Cancer Diagnosis and Outcomes in the Kaiser Permanente Northern California Population. Cancer Epidemiol Biomarkers Prev. 2017;26(1):30-37. doi:10.1158/1055-9965.EPI-16-0145.
  10. Alves Martins BA, de Bulhões GF, Cavalcanti IN, Martins MM, de Oliveira PG, Martins AMA. Biomarkers in Colorectal Cancer: The Role of Translational Proteomics Research. Front Oncol. 2019;9:1284. Published 2019 Nov 27. doi:10.3389/fonc.2019.01284.
  11. Nazha B, Moussaly E, Zaarour M, Weerasinghe C, Azab B. Hypoalbuminemia in colorectal cancer prognosis: Nutritional marker or inflammatory surrogate?. World J Gastrointest Surg. 2015;7(12):370-377. doi:10.4240/wjgs.v7.i12.370.
  12. Cruzat V, Macedo Rogero M, Noel Keane K, Curi R, Newsholme P. Glutamine: Metabolism and Immune Function, Supplementation and Clinical Translation. Nutrients. 2018;10(11):1564. doi:10.3390/nu10111564.
  13. Lee DW, Cho S, Shin A, Han SW, Kim TY. Body mass index and body weight change during adjuvant chemotherapy in colon cancer patients: results from the AVANT trial. Sci Rep. 2020;10(1):19467. Published 2020 Nov 10. doi:10.1038/s41598-020-76643-9.
  14. Auclin E, Taieb J, Lepage C, et al. Carcinoembryonic Antigen Levels and Survival in Stage III Colon Cancer: Post hoc Analysis of the MOSAIC and PETACC-8 Trials. Cancer Epidemiol Biomarkers Prev. 2019;28(7):1153-1161. doi:10.1158/1055-9965.EPI-18-0867.
  15. Konishi, T. et al., 2018. Association of Preoperative and Post-operative Serum Carcinoembryonic Antigen and Colon Cancer Outcome. JAMA Oncol, 4(3), pp. 309-315.
  16. Huang, C.S. et al., 2020. Post-operative serum carcinoembryonic antigen levels cannot predict survival in colorectal cancer patients with type II diabetes. J Chin Med Assoc, Volume 83, pp. 911-917.
  17. González-Trejo S, Carrillo JF, Carmona-Herrera DD, et al. Baseline serum albumin and other common clinical markers are prognostic factors in colorectal carcinoma: A retrospective cohort study. Medicine (Baltimore). 2017;96(15):e6610. doi:10.1097/MD.0000000000006610.
  18. Ling HH, Pan YP, Fan CW, et al. Clinical Significance of Serum Glutamine Level in Patients with Colorectal Cancer. Nutrients. 2019;11(4):898. Published 2019 Apr 21. doi:10.3390/nu11040898.
  19. Sirniö P et al. Alterations in serum amino-acid profile in the progression of colorectal cancer: Associations with systemic inflammation, tumour stage and patient survival. British Journal of Cancer, 2019;(120). p. 238–246. https://doi.org/10.1038/s41416-018-0357-6.

How to Cite

Muamar, M., Budhi, I. B., Soewoto, W., Agustriani, N., & Ismail, D. (2022). The role of post-operative glutamine serum level and one-year survival rate of stage III of colorectal cancer patients: a single center study. Bali Medical Journal, 11(3), 1223–1229. https://doi.org/10.15562/bmj.v11i3.3503

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