Clinical Score to Predict Recurrence in Patients with Stage II and Stage III Colon Cancer

SIMPLE SUMMARY: The prognosis of patients with stage II and stage III colon cancer is heterogeneous. Clinical and pathological characteristics may help to further refine the recurrence risk. We built a prognostic score and categorized patients into two risk groups in a training and validation cohort. We assigned two points to T4 and one point to N2 and high tumor budding based on the multivariate cox regression analysis for time to recurrence (TTR) in the training cohort. Forty-five percent of the patients were assigned to the low-risk group and compared to the high-risk group, had a significantly longer TTR. These results were confirmed in the validation cohort. ABSTRACT: Background: The prognosis of patients with stage II and stage III colon cancer is heterogeneous. Clinical and pathological characteristics, such as tumor budding, may help to further refine the recurrence risk. Methods: We included all the patients with localized colon cancer at Hospital Universitario La Paz from October 2016 to October 2021. We built a prognostic score for recurrence in the training cohort based on multivariate cox regression analysis and categorized the patients into two risk groups. Results: A total of 440 patients were included in the training cohort. After a median follow-up of 45 months, 81 (18%) patients had a first tumor recurrence. T4, N2, and high tumor budding remained with a p value <0.05 at the last step of the multivariate cox regression model for time to recurrence (TTR). We assigned 2 points to T4 and 1 point to N2 and high tumor budding. Forty-five percent of the patients were assigned to the low-risk group (score = 0). Compared to the high-risk group (score 1–4), patients in the low-risk group had a significantly longer TTR (hazard ratio for disease recurrence of 0.14 (95%CI: 0.00 to 0.90; p < 0.045)). The results were confirmed in the validation cohort. Conclusions: In our study, we built a simple score to predict tumor recurrence based on T4, N2, and high tumor budding. Patients in the low-risk group, that comprised 44% of the cohort, had an excellent prognosis.