Predictors of recurrence free survival for patients with stage II and III colon cancer

Vassiliki L. Tsikitis, David Larson, Marianne Huebner, Christine M. Lohse, Patricia A. Thompson

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Abstract

Background: The aim of this study was to evaluate clinico-pathologic specific predictors of recurrence for stage II/III disease. Improving recurrence prediction for resected stage II/III colon cancer patients could alter surveillance strategies, providing opportunities for more informed use of chemotherapy for high risk individuals.Methods: 871 stage II and 265 stage III patients with colon cancers were included. Features studied included surgery date, age, gender, chemotherapy, tumor location, number of positive lymph nodes, tumor differentiation, and lymphovascular and perineural invasion. Time to recurrence was evaluated, using Cox's proportional hazards models. The predictive ability of the multivariable models was evaluated using the concordance (c) index.Results: For stage II cancer patients, estimated recurrence-free survival rates at one, three, five, and seven years following surgery were 98%, 92%, 90%, and 89%. Only T stage was significantly associated with recurrence. Estimated recurrence-free survival rates for stage III patients at one, three, five, and seven years following surgery were 94%, 78%, 70%, and 66%. Higher recurrence rates were seen in patients who didn't receive chemotherapy (p = 0.023), with a higher number of positive nodes (p < 0.001). The c-index for the stage II model was 0.55 and 0.68 for stage III.Conclusions: Current clinic-pathologic information is inadequate for prediction of colon cancer recurrence after resection for stage II and IIII patients. Identification and clinical use of molecular markers to identify the earlier stage II and III colon cancer patients at elevated risk of recurrence are needed to improve prognostication of early stage colon cancers.

Original languageEnglish (US)
Article number336
JournalBMC Cancer
Volume14
Issue number1
DOIs
StatePublished - May 16 2014

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Colonic Neoplasms
Recurrence
Survival
Drug Therapy
Survival Rate
Neoplasms
Proportional Hazards Models
Lymph Nodes

Keywords

  • Chemotherapy
  • Clinico-pathologic
  • Disease-free survival
  • Early stage colon cancer
  • Predictors of recurrence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics
  • Medicine(all)

Cite this

Predictors of recurrence free survival for patients with stage II and III colon cancer. / Tsikitis, Vassiliki L.; Larson, David; Huebner, Marianne; Lohse, Christine M.; Thompson, Patricia A.

In: BMC Cancer, Vol. 14, No. 1, 336, 16.05.2014.

Research output: Contribution to journalArticle

Tsikitis, Vassiliki L. ; Larson, David ; Huebner, Marianne ; Lohse, Christine M. ; Thompson, Patricia A. / Predictors of recurrence free survival for patients with stage II and III colon cancer. In: BMC Cancer. 2014 ; Vol. 14, No. 1.
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AB - Background: The aim of this study was to evaluate clinico-pathologic specific predictors of recurrence for stage II/III disease. Improving recurrence prediction for resected stage II/III colon cancer patients could alter surveillance strategies, providing opportunities for more informed use of chemotherapy for high risk individuals.Methods: 871 stage II and 265 stage III patients with colon cancers were included. Features studied included surgery date, age, gender, chemotherapy, tumor location, number of positive lymph nodes, tumor differentiation, and lymphovascular and perineural invasion. Time to recurrence was evaluated, using Cox's proportional hazards models. The predictive ability of the multivariable models was evaluated using the concordance (c) index.Results: For stage II cancer patients, estimated recurrence-free survival rates at one, three, five, and seven years following surgery were 98%, 92%, 90%, and 89%. Only T stage was significantly associated with recurrence. Estimated recurrence-free survival rates for stage III patients at one, three, five, and seven years following surgery were 94%, 78%, 70%, and 66%. Higher recurrence rates were seen in patients who didn't receive chemotherapy (p = 0.023), with a higher number of positive nodes (p < 0.001). The c-index for the stage II model was 0.55 and 0.68 for stage III.Conclusions: Current clinic-pathologic information is inadequate for prediction of colon cancer recurrence after resection for stage II and IIII patients. Identification and clinical use of molecular markers to identify the earlier stage II and III colon cancer patients at elevated risk of recurrence are needed to improve prognostication of early stage colon cancers.

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