Long‐Term Follow‐Up of Patients Undergoing Resection of TNM Stage I Colorectal Cancer: An Analysis of Tumour and Host Determinants of Outcome

Mansouri, David; Powell, Arfon; Park, James H.; McMillan, Donald C.; Horgan, Paul G.

doi:10.1007/s00268-016-3443-z

Cited by 9 publications

(7 citation statements)

References 59 publications

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“…Recurrences are mainly attributed to greater malignancy and poor response to chemotherapy, suggesting that a non-invasive blood based test with high sensitivity and specificity for monitoring the recurrences in patients with CRC will greatly attributed to higher survival. Moreover, Pathological staging based on the Tumor-Node-Metastasis (TNM) system is currently the major prognostic indicator for patients with CRC [28], which is, however, not accounting for the heterogeneity of individual tumors, there is an increasing demand for biomarkers that are involved specifically in CRC progression, thus facilitating a more accurate prognostic stratification of the tumor to improve efficacy of multimodal therapy. Hence, the predictive factors of early postoperative relapse with high sensitivity and specificity to precisely and reliably diagnose CRC and provide patient follow-up procedures are critical features that must be considered.…”

Section: Discussionmentioning

confidence: 99%

Circulating MIC-1/GDF15 is a complementary screening biomarker with CEA and correlates with liver metastasis and poor survival in colorectal cancer

Wang

Yang

Tian³

et al. 2017

Oncotarget

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Macrophage inhibitory cytokine 1 (MIC-1/GDF15) has been characterized as a candidate biomarker for colorectal cancer (CRC) recently. However, the role of serum MIC-1 in screening patients with early stage CRC and monitoring therapeutic response have not been well-established, particularly in the combination with CEA for the screening and the prejudgment of occurrence with liver metastasis. In this study, we performed a retrospective blinded evaluation of 987 serum samples from 473 individuals with CRC, 25 with adenomatous polyps, and 489 healthy individuals using ELISA or immunoassay. The sensitivity of serum MIC-1 was 43.8% and 38.5% for CRC diagnosis and early diagnosis, respectively, which were independent of and comparatively higher than for CEA (36.6% and 27.3%) at comparable specificity. Serum MIC-1 after surgery were significantly elevated at the time of tumor recurrence, and notable increase were observed in 100% patients with liver metastasis. Besides the TNM classification and differentiation grade, MIC-1 was an independent prognostic factor contributing to overall survival. We conclude that MIC-1 can act as a candidate complementary biomarker for screening early-stage CRC by combination with CEA, and furthermore, for the first time, identify a promising prognostic indicator for monitoring recurrence with liver metastasis, to support strategies towards personalized therapy.

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Section: Discussionmentioning

confidence: 99%

Circulating MIC-1/GDF15 is a complementary screening biomarker with CEA and correlates with liver metastasis and poor survival in colorectal cancer

Wang

Yang

Tian³

et al. 2017

Oncotarget

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“…More recent studies have found an association of increased levels of inflammatory markers and increased mortality in CRC patients, but also in CRC patients stage I and in asymptomatic healthy individuals[ 9 - 12 ]. Our findings of a worse prognosis in association with increased level of inflammation may therefore be a more general phenomenon and not directly related to the cancer disease.…”

Section: Discussionmentioning

confidence: 99%

“…Increased levels of inflammatory factors have been associated with increased mortality in CRC patients, also in stage I which has a good oncological prognosis, but also in asymptomatic assumed healthy individuals[ 9 - 12 ].…”

Section: Introductionmentioning

confidence: 99%

Circulating inflammatory factors associated with worse long-term prognosis in colorectal cancer

Olsen¹,

Nijm²,

Andersson³

et al. 2017

WJG

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AIMTo investigate association of circulating inflammatory factors at the time of colorectal cancer (CRC) surgery with survival.METHODSPlasma levels from 174 CRC patients (69 females and 105 men), with median age 70 years (range 29-90), localized in the colon (n = 105) or rectum (n = 69), with stage I (n = 24), stage II (n = 54), stage III (n = 67) and stage IV (n = 29) were measured using commercially available Bio-Plex Pro™ Human Chemokine Panel 40-Plex, including 40 different chemokines, cytokines and interleukins. The prognostic association of each inflammatory factor was analysed as CRC-specific and total mortality.RESULTSOut of 174 patients, 66 died during the follow-up, 40 because of CRC specific mortality. High tertile levels of 8 factors were significantly associated with increased CRC-specific mortality, of which CCL1, CCL20, CCL24, CX3CL1, IL-4 and TNF-α remained significant in a multivariate Cox regression analysis. High tertile levels of 14 factors were associated with increased total mortality, of which CCL1, CCL15, CCL20, CX3CL1, CXCL13, IFN-γ, IL-2, IL-4 and IL-10 remained significant after adjustment for clinical covariates. For most of the inflammatory factors the association between higher tertile levels and an increased mortality in general appeared two years after surgery. High tertile levels of TNF-α and CCL24 were exclusively associated with CRC-specific mortality. The distribution of these factors were not associated with TNM stage with exception for CCL20.CONCLUSIONHigh plasma levels of inflammatory factors are associated with increased risk of mortality among CRC patients and could be potential biomarkers for revealing prognosis.

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“…Increased diagnosis of early-stage CRC may also be attributed to medical screening, such as colonoscopy [ 2 3 ]. The 5-year cancer-specific survival for TNM stage I CRC is over 90% [ 5 ]. As TNM stage I CRC has a low recurrence rate, few studies have evaluated the risk factors for its recurrence.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of recurrence in TNM stage I colorectal cancer

2023

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Purpose TNM stage I colorectal cancer (CRC) can recur, although the recurrence rate is low. Few studies have evaluated the risk factors for TNM stage I CRC recurrence. This study aimed to evaluate the TNM stage I CRC recurrence rate, as well as risk factors for recurrence. Methods In this retrospective study, we reviewed the database of patients who had undergone surgery for TNM stage I CRC between November 2008 and December 2014 without receiving neoadjuvant therapy or transanal excision for rectal cancer. Our analysis included 173 patients. Primary lesions were found in the colon of 133 patients and in the rectum of 40 patients. Results The CRC recurrence rate was 2.9% (5 out of 173 patients). For colon cancer patients, tumor size was not associated with higher recurrence risk (P = 0.098). However, for rectal cancer patients, both tumor size (≥3 cm) and T stage were associated with higher recurrence risk (P = 0.046 and P = 0.046, respectively). Of the 5 recurrent cases, 1 patient exhibited disease progression despite treatment, 1 patient maintained stable disease status after recurrence treatment, and 3 patients had no evidence of a tumor after recurrence treatment. Conclusion Our findings suggest that tumor size and T stage are predictors of stage I rectal cancer recurrence, and careful monitoring and follow-up of patients with larger tumors may be warranted.

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Long‐Term Follow‐Up of Patients Undergoing Resection of TNM Stage I Colorectal Cancer: An Analysis of Tumour and Host Determinants of Outcome

Cited by 9 publications

References 59 publications

Circulating MIC-1/GDF15 is a complementary screening biomarker with CEA and correlates with liver metastasis and poor survival in colorectal cancer

Circulating MIC-1/GDF15 is a complementary screening biomarker with CEA and correlates with liver metastasis and poor survival in colorectal cancer

Circulating inflammatory factors associated with worse long-term prognosis in colorectal cancer

Risk factors of recurrence in TNM stage I colorectal cancer

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