Abstract 504P
Background
α-Fetoprotein-positive colorectal cancer (AFPP-CRC) is a rare type of colorectal cancer (CRC), and there have been no comprehensive investigations on prognostic factors of AFPP-CRC. The aim of this study was to elucidate the prognostic factors of AFPP-CRC.
Methods
During the years of 2010 to 2020, 127 CRC patients with preoperative elevated serum AFP level were collected, after excluding the diagnosis of hepatitis, hepatocirrhosis and hepatocarcinoma. The AFPP-CRC group control was matched by 1:2 to the AFPN(α-Fetoprotein-negative)-CRC group after propensity score matching (PSM) analysis. Prognostic factors were investigated using univariate and multivariate Cox regression model. Kaplan-Meier curves were performed among the prognostic factors as well.
Results
After PSM analysis, these two groups were balanced for age, sex, and tumor stage. After adjusting for other confounding factors, AFP positivity and tumor stage were shown to be associated with poorer overall survival (OS) and disease-free survival (DFS). The median of OS was 26.4 months versus 30.3 months when comparing AFPP-CRC group versus AFPN-CRC group. The median of disease-free survival was 23.3 months in the AFPP-CRC group, as compared to 26.0 months in the AFPN-CRC group. Among AFPP-CRC patients, those who also had a worse prognosis were characterized by elevated serum CEA level (P<0.001), liver metastasis(P<0.001), nerve infiltration(P=0.009), peritoneal metastasis(P=0.02), poorer stage(P<0.001) and microsatellite stability (P=0.007).
Conclusions
We found higher serum AFP level before surgery was associated with worse OS in patients with CRC, even adjusting for tumor stage. Besides, AFPP-CRC with microsatellite stability might had a worse prognosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.