Tier 3 — preclinical

Circulating Metabolic Markers Identify Patients at Risk for Tumor Recurrence: A Prospective Cohort Study in Colorectal Cancer Surgery

Blanca Montcusí, Francisco Madrid-Gambin, Silvia Marin, Xavier Mayol, Marta Pascual, Marta Cascante, Óscar J Pozo, Miguel Pera

Annals of Surgery 2024 280(5):842-849

Bibliography

PubMed: PMID 39087328
DOI: 10.1097/SLA.0000000000006463
Competing interests: Authors reported no conflicts of interest.

Study snapshot

Design	Prospective cohort biomarker study
Model	Patients undergoing colorectal cancer surgery
Sample	146; 24 tumor recurrences
Intervention	No intervention; preoperative and postoperative plasma spermidine-pathway metabolites measured by mass spectrometry
Duration	Prospective oncologic follow-up after surgery
Endpoints	Tumor recurrence; Plasma spermidine; Spermine; Spermidine synthase; Spermine/arginine balance

What the study showed, in plain terms

In colorectal-cancer surgery patients, higher preoperative activity across the circulating spermidine pathway was associated with later tumor recurrence. Preoperative spermidine above the study's cut-off was associated with higher recurrence risk.

Key findings

This is important cancer-biology context, not evidence that dietary or supplemental spermidine causes recurrence. Tumors can alter polyamine metabolism, so circulating spermidine may function as a disease biomarker rather than an exposure marker.

What this study can and cannot tell us

Small number of recurrences, observational biomarker design and no assessment of spermidine supplementation. Disease-driven metabolism and reverse causation are plausible.

Editorial review

Reviewed by the Biohack Blueprint research team

Khaled Mahmoud