Validation of a modified clinical risk score to predict cancer‐specific survival for stage II colon cancer

Abstract

Many patients with stage II colon cancer will die of their disease despite curative surgery. Therefore, identification of patients at high risk of poor outcome after surgery for stage II colon cancer is desirable. This study aims to validate a clinical risk score to predict cancer-specific survival in patients undergoing surgery for stage II colon cancer. Patients undergoing surgery for stage II colon cancer in 16 hospitals in the West of Scotland between 2001 and 2004 were identified from a prospectively maintained regional clinical audit database. Overall and cancer-specific survival rates up to 5 years were calculated. A total of 871 patients were included. At 5 years, cancer-specific survival was 81.9% and overall survival was 65.6%. On multivariate analysis, age ≥75 years (hazard ratio (HR) 2.11, 95% confidence intervals (CI) 1.57–2.85; P<0.001) and emergency presentation (HR 1.97, 95% CI 1.43–2.70; P<0.001) were independently associated with cancer-specific survival. Age and mode of presentation HRs were added to form a clinical risk score of 0–2. The cancer-specific survival at 5 years for patients with a cumulative score 0 was 88.7%, 1 was 78.2% and 2 was 65.9%. These results validate a modified simple clinical risk score for patients undergoing surgery for stage II colon cancer. The combination of these two universally documented clinical factors provides a solid foundation for the examination of the impact of additional clinicopathological and treatment factors on overall and cancer-specific survival.

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

“…It is of interest to compare this to previous work in our geographical area that has identified that age and emergency presentation are associated with survival in Stage II disease [25]. In the present study when adjusted for the SIR, as evidenced by mGPS, emergency presentation failed to retain prognostic significance.…”

“…For example, several large prospective cohort studies have identified inflammatory mediators including as CRP and albumin, as being predictive of both all-cause, cancer-specific mortality and cardiovascular mortality in the over 50s [23,24]. It is of interest to compare this to previous work in our geographical area that has identified that age and emergency presentation are associated with survival in Stage II disease [25]. In the present study when adjusted for the SIR, as evidenced by mGPS, emergency presentation failed to retain prognostic significance.…”

Extracellular matrix-based gene signature for predicting prognosis in colon cancer and immune microenvironment

“…Due to the high clinical heterogeneity of CC, the conventional clinical features including the current American Joint Committee on Cancer (AJCC) staging, Tumor, Nodal Involvement, Metastasis (TNM) staging, and grade are insufficient for accurately predicting individualized prognosis (8)(9)(10)(11). Therefore, it is essential to establish novel and robust prognostic biomarker signatures to identify the molecular changes that can reliably estimate clinical outcomes of CC patients, which would have tremendous value of guiding appropriate individualized clinical managements and treatments for CC patients.…”

Different impact of anastomotic leak on long-term recurrence after surgery for rectal vs colonic cancer A systemic review and meta-analysis

“…Ten studies had multivariate HR of CSS [16,18,20,27,36,40,62,65,73,80] . AL was associated with a decreased CSS (HR 1.65 95% CI 1.13-2.42, p < 0.0001) (Figure S5).…”