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

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

    Research output: Contribution to journalArticle

    31 Citations (Scopus)

    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

    Fingerprint

    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; Larson, David W.; 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 ; Larson, David W. ; 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.
    @article{e730e3c8b0184c7a9285fdc6d2bad0f0,
    title = "Predictors of recurrence free survival for patients with stage II and III colon cancer",
    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.",
    keywords = "Chemotherapy, Clinico-pathologic, Disease-free survival, Early stage colon cancer, Predictors of recurrence",
    author = "Vassiliki Tsikitis and Larson, {David W.} and Marianne Huebner and Lohse, {Christine M.} and Thompson, {Patricia A.}",
    year = "2014",
    month = "5",
    day = "16",
    doi = "10.1186/1471-2407-14-336",
    language = "English (US)",
    volume = "14",
    journal = "BMC Cancer",
    issn = "1471-2407",
    publisher = "BioMed Central",
    number = "1",

    }

    TY - JOUR

    T1 - Predictors of recurrence free survival for patients with stage II and III colon cancer

    AU - Tsikitis, Vassiliki

    AU - Larson, David W.

    AU - Huebner, Marianne

    AU - Lohse, Christine M.

    AU - Thompson, Patricia A.

    PY - 2014/5/16

    Y1 - 2014/5/16

    N2 - 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.

    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.

    KW - Chemotherapy

    KW - Clinico-pathologic

    KW - Disease-free survival

    KW - Early stage colon cancer

    KW - Predictors of recurrence

    UR - http://www.scopus.com/inward/record.url?scp=84901347797&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84901347797&partnerID=8YFLogxK

    U2 - 10.1186/1471-2407-14-336

    DO - 10.1186/1471-2407-14-336

    M3 - Article

    VL - 14

    JO - BMC Cancer

    JF - BMC Cancer

    SN - 1471-2407

    IS - 1

    M1 - 336

    ER -