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A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study

BACKGROUND: The prognostic stratification of colon cancer using only the tumor-node-metastasis (TNM) stage has some limitations. We sought to increase the accuracy of stratifying patients with stage III colon cancer by constructing a prognostic model combining carcinoembryonic antigen (CEA) with TNM...

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Autores principales: Fan, Jin, Liu, Yanlong, Cai, Xin, Wang, Jingwen, Guo, Rui, Ji, Yuan, Li, Chao, Xu, Ye, Li, Xinxiang, Zhang, Chundong, Zhang, Rui, Zhu, Ji, Cai, Sanjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736239/
https://www.ncbi.nlm.nih.gov/pubmed/33335852
http://dx.doi.org/10.3389/fonc.2020.566784
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author Fan, Jin
Liu, Yanlong
Cai, Xin
Wang, Jingwen
Guo, Rui
Ji, Yuan
Li, Chao
Xu, Ye
Li, Xinxiang
Zhang, Chundong
Zhang, Rui
Zhu, Ji
Cai, Sanjun
author_facet Fan, Jin
Liu, Yanlong
Cai, Xin
Wang, Jingwen
Guo, Rui
Ji, Yuan
Li, Chao
Xu, Ye
Li, Xinxiang
Zhang, Chundong
Zhang, Rui
Zhu, Ji
Cai, Sanjun
author_sort Fan, Jin
collection PubMed
description BACKGROUND: The prognostic stratification of colon cancer using only the tumor-node-metastasis (TNM) stage has some limitations. We sought to increase the accuracy of stratifying patients with stage III colon cancer by constructing a prognostic model combining carcinoembryonic antigen (CEA) with TNM. METHODS: We retrospectively analyzed the data generated from stage III colon cancer patients who had early postoperative CEA measurement from 21 to 100 days after surgery from 2006 to 2017. CEA value was processed using restricted cubic splines (RCS) method. The prognostic model was developed using cox proportional hazards regression. RESULTS: The time later than 20 days after surgery was optimal for measuring CEA, which was determined by comparing the prognostic value for preoperative and postoperative CEA (N = 2,049), and by evaluating the relationship between the hazard ratio (HR) and postoperative CEA measuring time. Postoperative CEA, T stage and N stage were selected into the final model, and the mean integrated-AUC (iAUC) was 0.78 with 1,000 × bootstrap resampling, which was higher than the model using only T and N stages (TN model; mean iAUC, 0.66). The net reclassification improvement (NRI) was 15% when compared with TN model. Patients could be divided into high and low risk groups by the model, and 3-year disease-free survival (DFS) were 53.7% and 87.0%, respectively (HR, 4.30; 95% CI, 2.65 to 6.96; P < 0.001). Similar results were found in the validation set. CONCLUSIONS: Stage III colon cancer could be stratified more accurately using the new prognostic model combining postoperative CEA with T and N stage.
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spelling pubmed-77362392020-12-16 A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study Fan, Jin Liu, Yanlong Cai, Xin Wang, Jingwen Guo, Rui Ji, Yuan Li, Chao Xu, Ye Li, Xinxiang Zhang, Chundong Zhang, Rui Zhu, Ji Cai, Sanjun Front Oncol Oncology BACKGROUND: The prognostic stratification of colon cancer using only the tumor-node-metastasis (TNM) stage has some limitations. We sought to increase the accuracy of stratifying patients with stage III colon cancer by constructing a prognostic model combining carcinoembryonic antigen (CEA) with TNM. METHODS: We retrospectively analyzed the data generated from stage III colon cancer patients who had early postoperative CEA measurement from 21 to 100 days after surgery from 2006 to 2017. CEA value was processed using restricted cubic splines (RCS) method. The prognostic model was developed using cox proportional hazards regression. RESULTS: The time later than 20 days after surgery was optimal for measuring CEA, which was determined by comparing the prognostic value for preoperative and postoperative CEA (N = 2,049), and by evaluating the relationship between the hazard ratio (HR) and postoperative CEA measuring time. Postoperative CEA, T stage and N stage were selected into the final model, and the mean integrated-AUC (iAUC) was 0.78 with 1,000 × bootstrap resampling, which was higher than the model using only T and N stages (TN model; mean iAUC, 0.66). The net reclassification improvement (NRI) was 15% when compared with TN model. Patients could be divided into high and low risk groups by the model, and 3-year disease-free survival (DFS) were 53.7% and 87.0%, respectively (HR, 4.30; 95% CI, 2.65 to 6.96; P < 0.001). Similar results were found in the validation set. CONCLUSIONS: Stage III colon cancer could be stratified more accurately using the new prognostic model combining postoperative CEA with T and N stage. Frontiers Media S.A. 2020-12-01 /pmc/articles/PMC7736239/ /pubmed/33335852 http://dx.doi.org/10.3389/fonc.2020.566784 Text en Copyright © 2020 Fan, Liu, Cai, Wang, Guo, Ji, Li, Xu, Li, Zhang, Zhang, Zhu and Cai http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Fan, Jin
Liu, Yanlong
Cai, Xin
Wang, Jingwen
Guo, Rui
Ji, Yuan
Li, Chao
Xu, Ye
Li, Xinxiang
Zhang, Chundong
Zhang, Rui
Zhu, Ji
Cai, Sanjun
A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study
title A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study
title_full A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study
title_fullStr A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study
title_full_unstemmed A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study
title_short A Novel Prognostic Model Incorporating Carcinoembryonic Antigen in 3-Week or Longer Postoperative Period for Stage III Colon Cancer: A Multicenter Retrospective Study
title_sort novel prognostic model incorporating carcinoembryonic antigen in 3-week or longer postoperative period for stage iii colon cancer: a multicenter retrospective study
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736239/
https://www.ncbi.nlm.nih.gov/pubmed/33335852
http://dx.doi.org/10.3389/fonc.2020.566784
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