Clinical calculator for predicting freedom from recurrence after resection of stage I-III colon cancer in patients with microsatellite instability Journal Article
| Authors: | Bektas, A. B.; Hakki, L.; Khan, A.; Widmar, M.; Wei, I. H.; Pappou, E.; Smith, J. J.; Nash, G. M.; Paty, P. B.; Garcia-Aguilar, J.; Cercek, A.; Stadler, Z.; Segal, N. H.; Shia, J.; Gonen, M.; Weiser, M. R. |
| Article Title: | Clinical calculator for predicting freedom from recurrence after resection of stage I-III colon cancer in patients with microsatellite instability |
| Abstract: | PURPOSEOutcome for patients with nonmetastatic, microsatellite instability (MSI) colon cancer is favorable: however, high-risk cohorts exist. This study was aimed at developing and validating a nomogram model to predict freedom from recurrence (FFR) for patients with resected MSI colon cancer.PATIENTS AND METHODSData from patients who underwent curative resection of stage I, II, or III MSI colon cancer in 2014-2021 (model training cohort, 384 patients, 33 events; median follow-up, 38.8 months) were retrospectively collected from institutional databases. Variables associated with recurrence in multivariable analysis were selected for inclusion in the clinical calculator. The calculator's predictive accuracy was measured with the concordance index and validated using data from patients who underwent treatment for MSI colon cancer in 2007-2013 (validation cohort, 164 patients, eight events; median follow-up, 84.8 months).RESULTST category and number of positive lymph nodes were significantly associated with recurrence in multivariable analysis and were selected for inclusion in the clinical calculator. The calculator's concordance index for FFR in the model training cohort was 0.812 (95% CI, 0.742 to 0.873), compared with 0.759 (95% CI, 0.683 to 0.840) for the staging schema of the eighth edition of the American Joint Committee on Cancer Staging Manual. The concordance index for the validation cohort was 0.744 (95% CI, 0.666 to 0.822), confirming robust predictive accuracy.CONCLUSIONAlthough in general patients with nonmetastatic MSI colon cancer had favorable outcome, patients with advanced T category and multiple metastatic lymph nodes had higher risk of recurrence. The clinical calculator identified patients with MSI colon cancer at high risk for recurrence, and this could inform surveillance strategies. In addition, the model could be used in trial design to identify patients suitable for novel adjuvant therapy. © American Society of Clinical Oncology. |
| Keywords: | adult; human tissue; aged; middle aged; cancer surgery; retrospective studies; major clinical study; genetics; cancer recurrence; fluorouracil; cancer combination chemotherapy; cancer patient; cancer staging; follow up; neoplasm staging; neoplasm recurrence, local; carcinoembryonic antigen; colonic neoplasms; cohort analysis; pathology; retrospective study; high risk patient; proportional hazards model; nomograms; colonoscopy; tumor recurrence; folinic acid; colon cancer; adjuvant chemotherapy; colon tumor; microsatellite instability; lymph node; diagnosis; surgery; oxaliplatin; colon adenocarcinoma; nomogram; perineural invasion; time of death; colon surgery; clinical outcome; sigmoid; capecitabine plus oxaliplatin; transverse colon; humans; prognosis; human; male; female; article; antigen blood level; triplet chemotherapy; doublet chemotherapy |
| Journal Title: | JCO Clinical Cancer Informatics |
| Volume: | 8 |
| ISSN: | 2473-4276 |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2024-09-01 |
| Start Page: | e2300233 |
| Language: | English |
| DOI: | 10.1200/cci.23.00233 |
| PUBMED: | 39121392 |
| PROVIDER: | scopus |
| PMCID: | PMC11323037 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Martin R. Weiser -- Source: Scopus |
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