Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis
The survival rate for colon cancer after radical surgery has been the focus of extensive debate. To assess the postoperative survival and prognostic factors for overall survival (OS), we collected clinicopathological information for 2,655 patients. The survival time and potential risk factors for OS...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.914076/full |
| _version_ | 1811261394088099840 |
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| author | Xiangyi Pang Benjie Xu Jie Lian Ren Wang Xin Wang Jiayue Shao Shuli Tang Haibo Lu |
| author_facet | Xiangyi Pang Benjie Xu Jie Lian Ren Wang Xin Wang Jiayue Shao Shuli Tang Haibo Lu |
| author_sort | Xiangyi Pang |
| collection | DOAJ |
| description | The survival rate for colon cancer after radical surgery has been the focus of extensive debate. To assess the postoperative survival and prognostic factors for overall survival (OS), we collected clinicopathological information for 2,655 patients. The survival time and potential risk factors for OS were analyzed by using Kaplan–Meier curves, Cox proportional hazards models, best subset regression (BSR), and least absolute shrinkage and selection operator (LASSO). The 5-year survival rates of stage I–IV colon cancer were 96.6%, 88.7%, 69.9%, and 34.3%, respectively. Adjuvant chemotherapy improved the survival rate (90.4% vs. 82.4%, with versus without adjuvant chemotherapy, respectively) in stage II patients with high-risk factors. Elevated preoperative carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were significantly associated with worse OS compared with patients without these elevations. Less than 12 versus more than 12 harvested lymph nodes (LNs) affected prognosis (84.6% vs. 89.7%, respectively). Regarding the lymph node ratio (LNR), the 5-year OS rate was 89.2%, 71.5%, 55.8%, and 34.5% in patients with LNR values of 0, 0.3, 0.3–0.7, and >0.7, respectively. We constructed a nomogram comprising the independent factors associated with survival to better predict prognosis. On the basis of these findings, we propose that stage II colon cancer patients without high-risk factors and with both elevated preoperative CEA and CA199 should receive adjuvant therapy. Furthermore, the LNR could complement TNM staging in patients with <12 harvested LNs. Our nomogram might be useful as a new prognosis prediction system for colon cancer patients. |
| first_indexed | 2024-04-12T19:03:38Z |
| format | Article |
| id | doaj.art-b5403f5c740c45cb9d6983fa27cf3754 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-12T19:03:38Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-b5403f5c740c45cb9d6983fa27cf37542022-12-22T03:20:05ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.914076914076Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysisXiangyi PangBenjie XuJie LianRen WangXin WangJiayue ShaoShuli TangHaibo LuThe survival rate for colon cancer after radical surgery has been the focus of extensive debate. To assess the postoperative survival and prognostic factors for overall survival (OS), we collected clinicopathological information for 2,655 patients. The survival time and potential risk factors for OS were analyzed by using Kaplan–Meier curves, Cox proportional hazards models, best subset regression (BSR), and least absolute shrinkage and selection operator (LASSO). The 5-year survival rates of stage I–IV colon cancer were 96.6%, 88.7%, 69.9%, and 34.3%, respectively. Adjuvant chemotherapy improved the survival rate (90.4% vs. 82.4%, with versus without adjuvant chemotherapy, respectively) in stage II patients with high-risk factors. Elevated preoperative carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were significantly associated with worse OS compared with patients without these elevations. Less than 12 versus more than 12 harvested lymph nodes (LNs) affected prognosis (84.6% vs. 89.7%, respectively). Regarding the lymph node ratio (LNR), the 5-year OS rate was 89.2%, 71.5%, 55.8%, and 34.5% in patients with LNR values of 0, 0.3, 0.3–0.7, and >0.7, respectively. We constructed a nomogram comprising the independent factors associated with survival to better predict prognosis. On the basis of these findings, we propose that stage II colon cancer patients without high-risk factors and with both elevated preoperative CEA and CA199 should receive adjuvant therapy. Furthermore, the LNR could complement TNM staging in patients with <12 harvested LNs. Our nomogram might be useful as a new prognosis prediction system for colon cancer patients.https://www.frontiersin.org/articles/10.3389/fonc.2022.914076/fullcolon cancerradical surgerysurvival ratenomogramprognostic factors |
| spellingShingle | Xiangyi Pang Benjie Xu Jie Lian Ren Wang Xin Wang Jiayue Shao Shuli Tang Haibo Lu Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis Frontiers in Oncology colon cancer radical surgery survival rate nomogram prognostic factors |
| title | Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis |
| title_full | Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis |
| title_fullStr | Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis |
| title_full_unstemmed | Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis |
| title_short | Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis |
| title_sort | real world survival of colon cancer after radical surgery a single institutional retrospective analysis |
| topic | colon cancer radical surgery survival rate nomogram prognostic factors |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.914076/full |
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