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@ARTICLE{Damerell:293587,
      author       = {V. Damerell and N. Klaassen-Dekker and S. Brezina and J.
                      Ose and A. Ulvik and E. H. van Roekel and A. N. Holowatyj
                      and A. Baierl and J. Böhm and M. J. L. Bours and H.
                      Brenner$^*$ and J. H. W. de Wilt and W. M. Grady and N.
                      Habermann and M. Hoffmeister$^*$ and P. Keski-Rahkonen and
                      T. Lin and P. Schirmacher and P. Schrotz-King$^*$ and A. B.
                      Ulrich and F. J. B. van Duijnhoven and C. A. Warby and D.
                      Shibata and A. T. Toriola and J. C. Figueiredo and E. M.
                      Siegel and C. I. Li and A. Gsur and E. Kampman and M.
                      Schneider and P. M. Ueland and M. P. Weijenberg and C. M.
                      Ulrich and D. E. Kok and B. Gigic},
      collaboration = {F. Consortium},
      title        = {{C}irculating tryptophan-kynurenine pathway metabolites are
                      associated with all-cause mortality among patients with
                      stage {I}-{III} colorectal cancer.},
      journal      = {International journal of cancer},
      volume       = {156},
      number       = {3},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2024-01910},
      pages        = {552-565},
      year         = {2025},
      note         = {2025 Feb 1;156(3):552-565},
      abstract     = {Alterations within the tryptophan-kynurenine metabolic
                      pathway have been linked to the etiology of colorectal
                      cancer (CRC), but the relevance of this pathway for
                      prognostic outcomes in CRC patients needs further
                      elucidation. Therefore, we investigated associations between
                      circulating concentrations of tryptophan-kynurenine pathway
                      metabolites and all-cause mortality among CRC patients. This
                      study utilizes data from 2102 stage I-III CRC patients
                      participating in six prospective cohorts involved in the
                      international FOCUS Consortium. Preoperative circulating
                      concentrations of tryptophan, kynurenine, kynurenic acid
                      (KA), 3-hydroxykynurenine (HK), xanthurenic acid (XA),
                      3-hydroxyanthranilic acid (HAA), anthranilic acid (AA),
                      picolinic acid (PA), and quinolinic acid (QA) were measured
                      by liquid chromatography-tandem mass spectrometry. Using Cox
                      proportional hazards regression, we examined associations of
                      above-mentioned metabolites with all-cause mortality,
                      adjusted for potential confounders. During a median
                      follow-up of 3.2 years (interquartile range: 2.2-4.9), 290
                      patients $(13.8\%)$ deceased. Higher blood concentrations of
                      tryptophan, XA, and PA were associated with a lower risk of
                      all-cause mortality (per doubling in concentrations:
                      tryptophan: HR = 0.56; $95\%CI:0.41,0.76,$ XA: HR = 0.74;
                      $95\%CI:0.64,0.85,$ PA: HR = 0.76; $95\%CI:0.64,0.92),$
                      while higher concentrations of HK and QA were associated
                      with an increased risk of death (per doubling in
                      concentrations: HK: HR = 1.80; $95\%CI:1.47,2.21,$ QA: HR =
                      1.31; $95\%CI:1.05,1.63).$ A higher kynurenine-to-tryptophan
                      ratio, a marker of cell-mediated immune activation, was
                      associated with an increased risk of death (per doubling: HR
                      = 2.07; $95\%CI:1.52,2.83).$ In conclusion,
                      tryptophan-kynurenine pathway metabolites may be prognostic
                      markers of survival in CRC patients.},
      keywords     = {all‐cause mortality (Other) / colorectal cancer (Other) /
                      kynurenines (Other) / prognosis (Other) / tryptophan
                      (Other)},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39308420},
      doi          = {10.1002/ijc.35183},
      url          = {https://inrepo02.dkfz.de/record/293587},
}