Identification of Patients with High-Risk Stage II Colon Cancer for Adjuvant Therapy

Quah, Hak-Mien; Chou, Joanne F.; Gönen, Mithat; Shia, Jinru; Schrag, Deborah; Landmann, Ron G.; Guillem, José G.; Paty, Philip B.; Temple, Larissa K.; Wong, W. Douglas; Weiser, Martin R.

doi:10.1007/s10350-008-9246-z

Cited by 227 publications

(154 citation statements)

References 20 publications

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“…We believe that our data on p-CEA, along with data from other previously mentioned authors, can help in the stratification of patients with high risk of relapse, even independently from an advanced staging, 5,6,29,44 who can benefit most from both intra-or postoperative adjuvant therapies and tighter controls.…”

Section: Discussionmentioning

confidence: 51%

“…11 These observations, which were made as recently as 2013 and which still seem surprising after 30 years, are certainly not due to the lack of testing new molecular, genetic, or humoral markers, but to the fact that these are not reliable, simple, nor cost effective as the CEA could be. In recent years, we are not the only ones 1,3,4,6,7,10,11,16,18,19,[27][28][29] who believe that the determination of the p-CEA has a prognostic value in identifying, preoperatively, the group of patients who most likely will show recurrences. In fact, p-CEA is able to identify both patients whose understaging results from occult metastasis and those who are carriers of histologically advanced or more aggressive neoplasms.…”

Section: Discussionmentioning

confidence: 99%

“…It must be said, however, that most of the mentioned authors 1,[3][4][5]9,10,19,21,24,27,29,32,35 do not consider this variable in their clinical cases and that the only author 20 referring to it claim it has no impact on the CEA levels.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Destri

Rubino

Latino

et al. 2015

International Surgery

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To evaluate whether, in a sample of patients radically treated for colorectal carcinoma, the preoperative determination of the carcinoembryonic antigen (p-CEA) may have a prognostic value and constitute an independent risk factor in relation to disease-free survival. The preoperative CEA seems to be related both to the staging of colorectal neoplasia and to the patient's prognosis, although this-to date-has not been conclusively demonstrated and is still a matter of intense debate in the scientific community. This is a retrospective analysis of prospectively collected data. A total of 395 patients were radically treated for colorectal carcinoma. The preoperative CEA was statistically compared with the 2010 American Joint Committee on Cancer (AJCC) staging, the T and N parameters, and grading. All parameters recorded in our database were tested for an association with disease-free survival (DFS). Only factors significantly associated (P , 0.05) with the DFS were used to build multivariate stepwise forward logistic regression models to establish their independent predictors. A statistically significant relationship was found between p-CEA and tumor staging (P , 0.001), T (P , 0.001) and N parameters (P ¼ 0.006). In a multivariate analysis, the independent prognostic factors found were: p-CEA, stages N1 and N2 according to AJCC, and G3 grading (grade). A statistically significant difference (P , 0.001) was evident between the DFS of patients with normal and high p-CEA levels. Preoperative CEA makes a preoperative selection possible of those patients for whom it is likely to be able to predict a more advanced staging.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Destri

Rubino

Latino

et al. 2015

International Surgery

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“…Age, gender, TNM stage, venous invasion, tumour necrosis, peri-tumoural lymphocytic infiltration, tumour budding and CEA levels were also independently associated with poor survival in at least some studies [17,18,21,22,26,30,32,33,39].…”

Section: Discussionmentioning

confidence: 97%

The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: A systematic review

Wyk

Going

Horgan

et al. 2017

Critical Reviews in Oncology/Hematology

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. (2017) The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: a systematic review. Critical Reviews in Oncology/Hematology, 112, pp. 11-20. (doi:10.1016/j.critrevonc.2017 This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/139181/ Therefore, the aim of the present study was to systematically review the identification and associations of perineural invasion and survival in patients with primary operable colorectal cancer. From initial search results of 912 articles, 38 studies were selected. Using H&E stains; five studies including 1835 patients reported on survival stratified by perineural invasion in colon cancer with weighted average detection rates of 26%; eleven studies including 3837 patients reported on rectal cancer with weighted average detection rates of 25% and; sixteen studies including 9145 patients reported on survival stratified by perineural invasion in colorectal cancer with weighted average detection rates of 17%. Using special techniques (S100), six studies including 1458 patients reported on the identification of perineural invasion in colorectal cancer.In comparison to H&E staining alone, the use of immunohistochemistry with S100 increased the detection of perineural invasion to approximately 70%.However, those studies did not examine the relationship with outcomes, so further research is required to establish the clinical significance of perineural invasion detected by immunohistochemistry. In conclusion, perineural invasion deserves special attention for improved prognostic stratification in patients with colorectal cancer. Further work is required to standardise pathology assessment and reporting of perineural invasion, in particular its definition, use of special stains and routine inclusion in pathology practice. Reliable assessment is required for investigations into mechanisms of perineural invasion, its role tumour spread and prognostic value.

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“…12,13 Features that confer high risk of recurrence in stage II colon cancer include large tumors (T4), bowel perforation or obstruction, lymphovascular invasion, poorly differentiated histology, positive margins, or inadequate lymph node sampling. [14][15][16] Guideline recommendations for patients with stage III colorectal cancer are based on high-quality randomized controlled trials that have demonstrated that adjuvant chemotherapy for stage III colon cancer 17-21 and neoadjuvant radiation with or without chemotherapy for stage III rectal cancer [22][23][24][25][26] improve outcomes. Treatment of stage II colon and rectal cancers is more controversial.…”

Section: Introductionmentioning

confidence: 99%

Physicians’ Beliefs About the Benefits and Risks of Adjuvant Therapies for Stage II and Stage III Colorectal Cancer

Wong

Stock

Schrag

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Identification of Patients with High-Risk Stage II Colon Cancer for Adjuvant Therapy

Cited by 227 publications

References 20 publications

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: A systematic review

Physicians’ Beliefs About the Benefits and Risks of Adjuvant Therapies for Stage II and Stage III Colorectal Cancer

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