Abstract 1843
Background
There are limitations in the prognosis stratification of stage III colon cancer patients using only the T and N stages, while other factors are unsure to be equally important. This study aimed to prove the prognostic importance of postoperative carcinoembryonic antigen (CEA) and stratify patients with stage III colon cancer more accurately by building a prognostic model combining CEA.
Methods
This was a retrospective cohort study. Patients with colon cancer who had CEA recorded within 100 days after resection at the centers from 2006 to 2017 were identified. The data included three different cancer centers in China: one training set and two validation sets, which were collected and analyzed in 2018. Postoperative CEA, T stage and N stage were combined to build the prognostic model, and patients with stage III colon cancer were divided into the high-risk group and the low-risk group. Harrell’s C-statistics, and net reclassification improvement (NRI) were used to assess the model performance. The disease-free survival (DFS) was compared between the high-risk group and the low-risk groups by the log-rank test.
Results
Among patients with elevated postoperative CEA, we found that CEA tested within 20 days (early test group) after resection was not reliable, since DFS of the early test group was higher than that of the delayed test group (p = 0.006). So, 834 patients with stage III disease which had CEA data for 21-100 days after resection were analyzed. In the training set, C-index for the model (combining T stage, N stage and postoperative CEA) was 0.74. Patients with elevated postoperative CEA, T4b, N2b or T4aN2a were classified as the high-risk group, with 3-year DFS of 55.8%, which was lower than the value of 86.0% in the low-risk group [hazard ratio (HR), 4.03; 95% CI, 2.49-6.54; p < 0.001]. When compared to the TNM model, this new model achieved a 10% NRI. These results were confirmed in the validation sets.
Conclusions
Patients with stage III colon cancer could be stratified much more accurately with the prognostic model combining T stage, N stage and postoperative CEA.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Harbin Medical University Cancer Hospital Preeminence Youth Fund (JCQN2019-04).
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2786 - Development of a living organoid biobank derived from colorectal cancer patients: towards personalized medicine
Presenter: Federica Papaccio
Session: Poster Display session 2
Resources:
Abstract
3351 - Microsatellite Instability Detection in Colorectal Cancer: 44-Center Comparison between the Idylla MSI Assay and Routine Molecular and Immunohistochemistry Tests on Formalin-Fixed Paraffin-Embedded Tissue
Presenter: Xavier Matias-guiu
Session: Poster Display session 2
Resources:
Abstract
4901 - Expression profile of EPHB3 and its prognostic significance in colorectal cancer progression (Running head: Prognostic value of EPHB3 in colorectal cancers)
Presenter: Bogun Jang
Session: Poster Display session 2
Resources:
Abstract
5030 - A pan-ErbB family inhibitor, AF8c, promotes apoptosis by DR5/Nrf2 activation via ROS in colorectal cancer cells
Presenter: Soyeon Jeong
Session: Poster Display session 2
Resources:
Abstract
5053 - Frequent BRAF, GNAS and SMAD4 mutations identified in Colorectal Mucinous Carcinomas
Presenter: Sun Mi Lee
Session: Poster Display session 2
Resources:
Abstract
5220 - Impact of CCL4 knockout using CRISPR Cas-9 technology on colorectal tumor progression
Presenter: Roba Barakat
Session: Poster Display session 2
Resources:
Abstract
5330 - Independent clinical validation of a gene expression profile to predict benefit of 5-FU in metastatic colorectal cancer
Presenter: Ida Buhl
Session: Poster Display session 2
Resources:
Abstract
5515 - WRN mutated Colorectal Cancer (CRC) is characterized by a distinct molecular and immunological profile
Presenter: Andreas Seeber
Session: Poster Display session 2
Resources:
Abstract
5716 - Mutation analysis of B2M gene in colorectal cancer patients with microsatellite instability
Presenter: Ivana Kašubová
Session: Poster Display session 2
Resources:
Abstract
870 - Selective Wnt/β-catenin small-molecule inhibitor CWP232228 impairs tumor growth of colon cancer
Presenter: Jin Young Kim
Session: Poster Display session 2
Resources:
Abstract