Prognostic Value of Perioperative Serum Creatinine Kinase Levels for Metachronous Colorectal Liver Metastasis

Background: Although decreased serum creatine kinase (s-CK) levels are observed in some cancers, possibly due to consumption during tumor growth, the relationship between s-CK levels and colorectal liver metastasis remains unclear. This study investigated the prognostic significance of perioperative s-CK levels in patients with metachronous colorectal liver metastasis. Methods: A total of 46 patients who underwent liver resection from 2011 to 2023 were included in this study. The s-CK levels were assessed before liver resection and six months after liver resection. The patients were categorized into low or high s-CK groups, and the lower limit of normal s-CK levels was set as the cutoff value. The prognostic significance for recurrence-free survival (RFS) and overall survival (OS) was analyzed. Results: There was no significant difference in RFS or OS between the preoperative low and preoperative high s-CK groups (P = 0.089, P = 0.132, respectively). There was a significant difference in RFS between the postoperative low and postoperative high s-CK groups (P = 0.001). However, there was no significant difference in OS between these groups (P = 0.072). Patients with consistently low s-CK levels before and six months after liver resection showed significantly poorer RFS (P = 0.002) and poorer OS (P = 0.038) compared with patients who had consistently high s-CK levels. Conclusion: Perioperative s-CK levels may be useful as predictors of prognosis in patients with metachronous colorectal liver metastasis. Patients with consistently low perioperative s-CK levels may have a high risk for recurrence and mortality.