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@ARTICLE{Boakye:163861,
      author       = {D. Boakye$^*$ and L. Jansen$^*$ and B. Schöttker$^*$ and
                      E. H. J. M. Jansen and M. Schneider and N. Halama$^*$ and X.
                      Gào$^*$ and J. Chang‐Claude$^*$ and M. Hoffmeister$^*$
                      and H. Brenner$^*$},
      title        = {{B}lood markers of oxidative stress are strongly associated
                      with poorer prognosis in colorectal cancer patients},
      journal      = {International journal of cancer},
      volume       = {147},
      number       = {9},
      issn         = {1097-0215},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2020-02095},
      pages        = {2373 - 2386},
      year         = {2020},
      note         = {Int. J. Cancer. 2020;147:2373–2386#EA:C070#LA:C070#},
      abstract     = {Oxidative stress has been implicated in the initiation of
                      several cancers, including colorectal cancer (CRC). Whether
                      it also plays a role in CRC prognosis is unclear. We
                      assessed the associations of two oxidative stress biomarkers
                      (Diacron's reactive oxygen metabolites [d-ROMs] and total
                      thiol level [TTL]) with CRC prognosis. CRC patients who were
                      diagnosed in 2003 to 2012 and recruited into a
                      population-based study in Germany (n = 3361) were followed
                      for up to 6 years. Hazard ratios (HRs) and $95\%$ confidence
                      intervals $(95\%$ CIs) for the associations of d-ROMs and
                      TTL (measured from blood samples collected shortly after CRC
                      diagnosis) with overall survival (OS) and disease-specific
                      survival (DSS) were estimated using multivariable Cox
                      regression. Particularly pronounced associations of higher
                      d-ROMs with lower survival were observed in stage IV
                      patients, with patients in the highest (vs lowest) tertile
                      having much lower OS (HR = 1.52, $95\%$ CI = 1.14-2.04) and
                      DSS (HR = 1.61, $95\%$ CI = 1.20-2.17). For TTL, strong
                      inverse associations of TTL with mortality were observed
                      within all stages. In patients of all stages, those in the
                      highest (vs lowest) quintile had substantially higher OS (HR
                      = 0.48, $95\%$ CI = 0.38-0.62) and DSS (HR = 0.52, $95\%$ CI
                      = 0.39-0.69). The addition of these biomarkers to models
                      that included age, sex, tumor stage and subsite
                      significantly improved the prediction of CRC prognosis. The
                      observed strong associations of higher d-ROMs and lower TTL
                      levels with poorer prognosis even in stage IV patients
                      suggest that oxidative stress contributes significantly to
                      premature mortality in CRC patients and demonstrate a large
                      potential of these biomarkers in enhancing the prediction of
                      CRC prognosis beyond tumor stage.},
      cin          = {D240 / C070 / C120 / HD01 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)D240-20160331 / I:(DE-He78)C070-20160331 /
                      I:(DE-He78)C120-20160331 / I:(DE-He78)HD01-20160331 /
                      I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32319674},
      doi          = {10.1002/ijc.33018},
      url          = {https://inrepo02.dkfz.de/record/163861},
}