Individualized Prediction of Colon Cancer Recurrence Using a Nomogram

Weiser, Martin R.; Landmann, Ron G.; Kattan, Michael W.; Gönen, Mithat; Shia, Jinru; Chou, Joanne F.; Paty, Philip B.; Guillem, José G.; Temple, Larissa K.; Schrag, Deborah; Saltz, Leonard B.; Wong, W. Douglas

doi:10.1200/jco.2007.14.1291

Cited by 256 publications

(214 citation statements)

References 19 publications

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“…Previous studies showed a prevalence of around 6% for NI in colon cancer that is indeed one of the lowest prevalence rates among all cancers, whereas in our study NI could be detected in 31.2% of all cases (16). This high discrepancy is likely to be the result of 2 key histopathologic factors: first, the presented comprehensive definition of NI and second, the fact that the main focus of our study was solely the pathobiology of NI.…”

Section: Discussioncontrasting

confidence: 51%

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The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

Liebl

Demir

Rosenberg

et al. 2013

Clinical Cancer Research

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Purpose: Neural invasion (NI) is a histopathologic feature of colon cancer that receives little consideration. Therefore, we conducted a morphologic and functional characterization of NI in colon cancer.Experimental Design: NI was investigated in 673 patients with colon cancer. Localization and severity of NI was determined and related to patient's prognosis and survival. The neuro-affinity of colon cancer cells (HT29, HCT-116, SW620, and DLD-1) was compared with pancreatic cancer (T3M4 and SU86.86) and rectal cancer cells (CMT-93) in the in vitro three-dimensional (3D)-neural-migration assay and analyzed via live-cell imaging. Immunoreactivity of the neuroplasticity marker GAP-43, and the neurotrophic-chemoattractant factors Artemin and nerve growth factor (NGF), was quantified in colon cancer and pancreatic cancer nerves. Dorsal root ganglia of newborn rats were exposed to supernatants of colon cancer, rectal cancer, and pancreatic cancer cells and neurite density was determined.Results: NI was detected in 210 of 673 patients (31.2%). Although increasing NI severity scores were associated with a significantly poorer survival, presence of NI was not an independent prognostic factor in colon cancer. In the 3D migration assay, colon cancer and rectal cancer cells showed much less neuritetargeted migration when compared with pancreatic cancer cells. Supernatants of pancreatic cancer and rectal cancer cells induced a much higher neurite density than those of colon cancer cells. Accordingly, NGF, Artemin, and GAP-43 were much more pronounced in nerves in pancreatic cancer than in colon cancer.Conclusion: NI is not an independent prognostic factor in colon cancer. The lack of a considerable biologic affinity between colon cancer cells and neurons, the low expression profile of colonic nerves for chemoattractant molecules, and the absence of a major neuroplasticity in colon cancer may explain the low prevalence and impact of NI in colon cancer.

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Section: Discussioncontrasting

confidence: 51%

“…NI prevalence varies considerably among different cancers, with up to 100% in pancreatic cancer, and low frequency in colon cancer (6%-19%; refs. 15,16). The reasons for the variable NI rates remain unknown.…”

Section: Introductionmentioning

confidence: 99%

The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

Liebl

Demir

Rosenberg

et al. 2013

Clinical Cancer Research

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“…Reporting of the results based on stage may not be sensitive enough since there is high variability in prognosis within each TNM stage [88] . Valentini et al [89] produced nomograms based on the data from five major European RCTs on adjuvant chemotherapy in rectal cancer (n = 2795), which take into account a large number of clinical and pathological variables.…”

Section: Future Directions and Trials In Progressmentioning

confidence: 99%

Adjuvant chemotherapy for rectal cancer: Is it needed?

Milinis

Thornton

Montazeri

et al. 2015

WJCO

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Adjuvant chemotherapy has become a standard treatment of advanced rectal cancer in the West. The benefits of adjuvant chemotherapy after surgery alone have been well established. However, controversy surrounds the use adjuvant chemotherapy in patients who received preoperative chemoradiotherapy, despite it being recommended by a number of international guidelines. Results of recent multicentre randomised control trials showed no benefit of adjuvant chemotherapy in terms of survival and rates of distant metastases. However, concerns exist regarding the quality of the studies including inadequate staging modalities, out-dated chemotherapeutic regimens and surgical approaches and small sample sizes. It has become evident that not all the patients respond to adjuvant chemotherapy and more personalised approach should be employed when considering the benefits of adjuvant chemotherapy. The present review discusses the strengths and weaknesses of the current evidence-base and suggests improvements for future studies.

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“…Forty percent of these will have a poor prognosis for which targeted therapeutic strategies could most likely be more effective. [1][2][3] For this reason, finding prognostic factors that are early, reliable, and related to the extent of the tumor is of the utmost importance. Among these, the most that are considered even to this day are T and N parameters.…”

mentioning

confidence: 99%

“…In fact, the prognosis of patients with the same staging is often various and that the need to continually implement ever-changing variables in an already excessively fragmented staging is still present. 2,4,[7][8][9] Recently, in light of these needs, great attention has been paid to the study of molecular and genetic markers. At present, these markers still have not found a regular application due to the complexity of their determination, the difficulty of standardization and, last but not least, the low cost-benefit ratio.…”

mentioning

confidence: 99%

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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Individualized Prediction of Colon Cancer Recurrence Using a Nomogram

Cited by 256 publications

References 19 publications

The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

Adjuvant chemotherapy for rectal cancer: Is it needed?

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

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