scholarly journals Mortality by Stage for Right- Versus Left-Sided Colon Cancer: Analysis of Surveillance, Epidemiology, and End Results–Medicare Data

2011 ◽  
Vol 29 (33) ◽  
pp. 4401-4409 ◽  
Author(s):  
Jennifer M. Weiss ◽  
Patrick R. Pfau ◽  
Erin S. O'Connor ◽  
Jonathan King ◽  
Noelle LoConte ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cox Regression ◽  
Stage Ii ◽  
Lower Mortality ◽  
Stage Iii ◽  
Primary Adenocarcinoma ◽  
Colon Cancers ◽  
Medicare Data ◽  
Significant Difference ◽  
End Results

Purpose Recent studies have reported increased mortality for right-sided colon cancers but had limited adjustment for patient characteristics and conflicting results by stage. We examined the relationship between colon cancer location (right- v left-side) and 5-year mortality by stage. Patients and Methods We identified Medicare beneficiaries from 1992 to 2005 with American Joint Commission on Cancer stages I to III primary adenocarcinoma of the colon who underwent surgery for curative intent through Surveillance, Epidemiology, and End Results (SEER) –Medicare data. Adjusted hazard ratios (HRs) and 95% CIs for predictors of all-cause 5-year mortality were obtained by using Cox proportional hazards regression. Results Of 53,801 patients, 67% had right-sided colon cancer. Patients with right-sided cancer were more likely to be older, to be women, to be diagnosed with a more advanced stage, and to have more poorly differentiated tumors. Adjusted Cox regression showed no significant difference in mortality between right- and left-sided cancers for all stages combined (HR, 1.01; 95% CI, 0.98 to 1.04; P = .598) or for stage I cancers (HR, 0.95; 95% CI, 0.88 to 1.03; P = .211). Stage II right-sided cancers had lower mortality than left-sided cancers (HR, 0.92; 95% CI, 0.87 to 0.97; P = .001), and stage III right-sided cancers had higher mortality (HR, 1.12; 95% CI, 1.06 to 1.18; P < .001). Conclusion When analysis was adjusted for multiple patient, disease, comorbidity, and treatment variables, no overall difference in 5-year mortality was seen between right- and left-sided colon cancers. However, within stage II disease, right-sided cancers had lower mortality; within stage III, right-sided cancers had higher mortality.

Impact of tumor side on clinical outcomes in stage II and III colon cancer with known microsatellite instability status.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4068-4068
Author(s):  
Katerina Mary Zakka ◽  
Shayla Williamson ◽  
Renjian Jiang ◽  
Olatunji B. Alese ◽  
Walid Labib Shaib ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Microsatellite Instability ◽  
Clinical Outcomes ◽  
Early Stage ◽  
Stage Ii ◽  
Stage Iii ◽  
Primary Adenocarcinoma ◽  
Rank Test ◽  
Significant Difference ◽  
The Impact

4068 Background: Microsatellite instability high (MSI-H) status indicates better prognosis in early stage colon cancer (CC) compared to microsatellite stable (MSS). However, the impact of tumor side, left side (L) versus right side (R), is not described on clinical outcomes based on MSI status. Methods: Patients with pathological stage II and III primary adenocarcinoma of the colon between 2010 and 2015 were identified in the National Cancer Database (NCDB) using ICD-O-3 morphology and topography codes: 8140-47, 8210-11, 8220-21, 8260-63, 8480-81, 8490 and C18.0, 18.2,18.3, 18.5,18.6, 18.7. Univariate (UVA) and multivariable (MVA) survival analyses were conducted, and Kaplan-Meier Curves were used to compare overall survival (OS) based on tumor location and treatment received with Log-rank test. Results: A total of 35,071 patients with stage II (n = 17,629) and III (n = 17,442) CC were identified. 51.3% female; 81.5% Caucasian; median age 66 (range, 18-90). Majority of stage II and III tumors were R, 61.2% (n = 10,794) and 56.0% (n = 9,763). MSI-H was more common in stage II compared to III, 23.3% (n = 4,115) vs 18.2% (n = 3,171) (p < 0.0001). Survival was better in stage II MSI-H compared to MSS, 5 year-OS 75.1% vs 71.8% (p = 0.0057). However, stage III CC survival was better in MSS compared to MSI-H, 5-year OS 60.5% vs 58.0% (p < 0.001). In stage II MSI-H CC R was more common than left, 78.3 % (n = 3223) vs 21.7% (n = 892). There was no significant difference in survival between stage II MSI-H L vs R (5-year OS 76.2% vs 74.7%, p = 0.1578). Stage II MSS CC R was more common than L, 56.0% (n = 7571) vs 44.0% (n = 5943), and survival was better in L vs R (5-year OS 73.2% vs 70.8%, p = 0.0029). Stage III MSI-H CC was more common in R than L, 75.6% (n = 2397) vs 24.4% (n = 774) and survival was better in L (5-year OS 62.5% vs 56.5%, p = 0.0026). Stage III MSS CC was more common in R than L, 51.6% (n = 7366) vs 48.4% (n = 6905), and survival was better in L vs R (5-year OS 67.0% vs 54.4%, p < 0.001). Conclusions: Survival was better in left sided tumors compared to right in stage II MSS, stage III MSS and stage III MSI-H CC.

scholarly journals Impact of Tumor Side on Clinical Outcomes in Stage II and III Colon Cancer With Known Microsatellite Instability Status

2021 ◽  
Vol 11 ◽  
Author(s):  
Mehmet Akce ◽  
Katerina Zakka ◽  
Renjian Jiang ◽  
Shayla Williamson ◽  
Olatunji B. Alese ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Microsatellite Instability ◽  
Clinical Outcomes ◽  
Stage Ii ◽  
Stage Iii ◽  
Primary Adenocarcinoma ◽  
Rank Test ◽  
Significant Difference ◽  
The Right ◽  
The Impact

BackgroundTumor sidedness as a prognostic factor in advanced stage colon cancer (CC) is well established. The impact of tumor sidedness on the clinical outcomes of stage II and III CC has not been well studied.MethodsThe National Cancer Database (NCDB) was utilized to identify patients with pathological stage II and III primary adenocarcinoma of the colon from 2010 to 2015 using ICD-O-3 morphology and topography codes: 8140-47, 8210-11, 8220-21, 8260-63, 8480-81, 8490 and C18.0, 18.2,18.3, 18.5,18.6, 18.7. Univariate (UVA) and multivariable (MVA) survival analyses and Kaplan–Meier Curves with Log-rank test were utilized to compare overall survival (OS) based on tumor location and treatment received.ResultsA total of 35,071 patients with stage II (n = 17,629) and III (n = 17,442) CC were identified. 51.3% female; 81.5% Caucasian; median age 66 (range, 18–90). Majority of stage II and III tumors were right sided, 61.2% (n = 10,794) and 56.0% (n = 9,763). Microsatellite instability high (MSI-H) was more common in stage II compared to III, 23.3% (n = 4,115) vs 18.2% (n = 3,171) (p &lt; 0.0001). In stage II MSI-H CC right was more common than left, 78.3% (n = 3223) vs 21.7% (n = 892). There was no significant difference in survival between stage II MSI-H left vs right (5-year OS 76.2 vs 74.7%, p = 0.1578). Stage II MSS CC right was more common than left, 56.0% (n = 7571) vs 44.0% (n = 5943), and survival was better in the left vs right (5-year OS 73.2 vs 70.8%, p = 0.0029). Stage III MSI-H CC was more common in the right than in the left, 75.6% (n = 2,397) vs 24.4% (n = 774) and survival was better in the left (5-year OS 62.5 vs 56.5%, p = 0.0026). Stage III MSS CC was more common in the right than in the left, 51.6% (n = 7,366) vs 48.4% (n = 6,905), and survival was better in the left vs right (5-year OS 67.0 vs 54.4%, p &lt; 0.001).ConclusionSurvival was better in left sided tumors compared to right in stage II MSS, stage III MSS, and stage III MSI-H CC.

Can sidedness predict for survival in primary locoregional colon cancers?

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 584-584
Author(s):  
Weining Wang ◽  
Chin Jin Seo ◽  
Grace Hwei Ching Tan ◽  
Claramae Shulyn Chia ◽  
Khee Chee Soo ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Cox Regression ◽  
Rank Test ◽  
Rectosigmoid Junction ◽  
Colon Cancers ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Impact

584 Background: Right and left-sided colon cancers are embryonically distinct and present differently. Recently, there has been growing belief that sidedness could be independently associated with survival outcomes. This has important clinical implications regarding the prognostication, management and surveillance of colon cancer patients. Hence, we aim to investigate the impact of sidedness on survival in our patient population in this study. Methods: Patients who had primary treatment naïve colon cancer who underwent curative surgical resection in our institution from September 2002 to December 2010 were included in this study. Demographic and clinicopathological data was collected from electronic records and clinical charts. Tumours arising from the cecum, ascending colon, hepatic flexure and transverse colon were considered right-sided, while those arising from splenic flexure and descending colon were considered left-sided. Cancers of the rectosigmoid junction and rectum were excluded. Kaplan-Meier curves and log-rank test were used to compare overall, locoregional recurrence-free and distant recurrence-free survivals (OS, LRFS, DRFS respectively) between both groups. Multivariate analysis was performed using Cox regression proportional hazards. Results: 389 patients were included in this study. 238 had left-sided tumours while the remaining 151 had right-sided tumours. In our cohort, right-sided tumours were associated with older age and mucinous histology. Kaplan-Meier curves plotted showed improved LRFS in left-sided tumours (p = 0.04, median survival not reached) but no significant difference in OS and DRFS. On multivariate analysis, sidedness was also found to be an independent prognostic factor for LRFS but not OS and DRFS despite factoring in age, size of tumour, pT, pN and histology. Conclusions: Our study suggests that left-sided tumours in primary colon cancer are independently prognostic for improved locoregional survival as compared to the right-sided tumours, even after taking into account other known factors such as age, staging and histology.

Does hospital academic status impact colon cancer care value?

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 6-6
Author(s):  
Christine Marie Veenstra ◽  
Andrew J Epstein ◽  
Craig Evan Pollack ◽  
Katrina Armstrong
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Cancer Care ◽  
Cost Of Care ◽  
Stage Ii ◽  
Stage Iii ◽  
Academic Status ◽  
Risk Of Death ◽  
Academic Hospitals ◽  
Significant Difference

6 Background: Given the high cost of cancer care, delivery of high-value care is crucial. The effect of hospital academic status on value of care for patients with stage II and III colon cancer is unknown. Methods: SEER-Medicare cohort study of 20,118 patients age 66+ with stage II or III colon cancer diagnosed 2000-2005 and followed through December 31, 2007. Patients were assigned to a treating hospital based on hospital affiliation of the primary oncologist. We constructed Kaplan-Meier curves to assess unadjusted overall survival. We estimated a Cox proportional hazards model to assess adjusted overall survival. To examine associations between hospital academic status and mean cost of care we estimated a generalized linear model (GLM) with log link and gamma family. We estimated quantile regression models to examine associations between hospital teaching status and cost at various quantiles (25th, 50th, 75th, 90th, 95th, 99th, 99.5th, 99.9th). Standard errors were adjusted to account for clustering of patients within hospitals. Results: 4449/20,118 (22%) patients received care from providers affiliated with academic hospitals. There was no significant difference in unadjusted median survival based on hospital academic status for patients with stage II (academic 6.4 yrs vs. non-academic 6.3 yrs, p=0.711) or stage III disease (academic 4.2 yrs vs. non-academic 4.2 yrs, p=0.81). After adjustment, treatment at academic hospitals was not associated with significantly reduced risk of death from colon cancer (stage II HR 1.05, 95% CI: 0.97 - 1.13; p=0.23; stage III HR 0.99, 95% CI: 0.94-1.07; p=0.98). Excepting stage III patients at the 99.9th percentile of costs, there were no significant differences in adjusted costs between academic and non-academic hospitals. Conclusions: We find no difference in overall survival for patients with stage II or stage III colon cancer based on academic status of the treating hospital. Furthermore, costs of care are similar between academic and non-academic hospitals across virtually the full range of the cost distribution. Most colon cancer patients do not receive cancer care at academic hospitals. Our findings indicate that for patients with stage II or III disease, this inequity does not impact the value of care.

scholarly journals Validation of the 12-Gene Colon Cancer Recurrence Score in NSABP C-07 As a Predictor of Recurrence in Patients With Stage II and III Colon Cancer Treated With Fluorouracil and Leucovorin (FU/LV) and FU/LV Plus Oxaliplatin

2013 ◽  
Vol 31 (36) ◽  
pp. 4512-4519 ◽  
Author(s):  
Greg Yothers ◽  
Michael J. O'Connell ◽  
Mark Lee ◽  
Margarita Lopatin ◽  
Kim M. Clark-Langone ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Therapy ◽  
Cox Regression ◽  
Cancer Recurrence ◽  
Recurrence Score ◽  
Recurrence Risk ◽  
Stage Ii ◽  
Stage Iii ◽  
Treatment Benefit ◽  
Stage Ii Colon Cancer

Purpose Accurate assessments of recurrence risk and absolute treatment benefit are needed to inform colon cancer adjuvant therapy. The 12-gene Recurrence Score assay has been validated in patients with stage II colon cancer from the Cancer and Leukemia Group B 9581 and Quick and Simple and Reliable (QUASAR) trials. We conducted an independent, prospectively designed clinical validation study of Recurrence Score, with prespecified end points and analysis plan, in archival specimens from patients with stage II and III colon cancer randomly assigned to fluorouracil (FU) or FU plus oxaliplatin in National Surgical Adjuvant Breast and Bowel Project C-07. Methods Recurrence Score was assessed in 892 fixed, paraffin-embedded tumor specimens (randomly selected 50% of patients with tissue). Data were analyzed by Cox regression adjusting for stage and treatment. Results Continuous Recurrence Score predicted recurrence (hazard ratio for a 25-unit increase in score, 1.96; 95% CI, 1.50 to 2.55; P < .001), as well as disease-free and overall survival (both P < .001). Recurrence Score predicted recurrence risk (P = .001) after adjustment for stage, mismatch repair, nodes examined, grade, and treatment. Recurrence Score did not have significant interaction with stage (P = .90) or age (P = .76). Relative benefit of oxaliplatin was similar across the range of Recurrence Score (interaction P = .48); accordingly, absolute benefit of oxaliplatin increased with higher scores, most notably in patients with stage II and IIIA/B disease. Conclusion The 12-gene Recurrence Score predicts recurrence risk in stage II and stage III colon cancer and provides additional information beyond conventional clinical and pathologic factors. Incorporating Recurrence Score into the clinical context may better inform adjuvant therapy decisions in stage III as well as stage II colon cancer.

Predictive factors for the underutilization of adjuvant chemotherapy in colon cancer in Southwestern Sydney

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6070-6070
Author(s):  
W. L. Ng ◽  
G. Gabriel ◽  
E. Moylan
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Predictive Factors ◽  
Predictive Factor ◽  
Treatment Guidelines ◽  
Stage Ii ◽  
Stage Iii ◽  
Utilization Rate ◽  
Co Morbidity ◽  
Significant Difference

6070 Background: Adjuvant chemotherapy improves survival in stage III and high risk stage II colon cancers and is therefore recommended in current treatment guidelines. Despite this, retrospective studies demonstrate that utilization rates remain suboptimal in Australia and other countries. In this study we aimed to identify predictive factors for adjuvant chemotherapy underutilization in the Southwestern Sydney Area Health Service (SWSAHS). Methods: We examined data collected on all patients with a diagnosis of stage II or III colon and rectosigmoid cancers from SWSAHS colorectal database between 1997 and 2003. Follow-up and survival were calculated until October 2005. SPSS was used for statistical analysis and Kaplan-Meier for survival analysis. Results: 704 patients were identified. The overall adjuvant chemotherapy utilization rate was 48% (68% for stage III and 26% for stage II). Overall 5 year survival was 69% for patients who received adjuvant chemotherapy compared with 39% for those who did not receive chemotherapy (p<0.001). The main predictive factor identified for not receiving chemotherapy in both stages was increasing age. Rates of utilization of adjuvant chemotherapy for stage III colon cancer were 90% (<50 yrs), 81% (50–69 yrs) and 50% (70+ yrs). The trend was similar for stage II patients with corresponding utilization rates of 69%, 37% and 10%, respectively. The difference in chemotherapy utilization by age groups is highly significant (p<0.001). Other factors including sex, health insurance status, site of primary colon cancer and index of relative socioeconomic disadvantage did not show significant difference in chemotherapy usage. We were unable to evaluate the effect of co-morbidity on chemotherapy use from our database. Conclusions: Increasing age is the single most important predictive factor in the underutilization of adjuvant chemotherapy in colon cancer despite evidence that the elderly can accrue the same benefit from adjuvant chemotherapy as their younger counterparts. No significant financial relationships to disclose.

Validation of two gene-expression risk scores in a large colon cancer cohort and contribution to an improved prognostic method.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3509-3509 ◽  
Author(s):  
Arnaud Roth ◽  
Antonio Fabio Di Narzo ◽  
Sabine Tejpar ◽  
Fred Bosman ◽  
Vlad Calin Popovici ◽  
...  
Keyword(s):  
Gene Expression ◽  
Colon Cancer ◽  
Cox Regression ◽  
Tnm Staging ◽  
Stage Ii ◽  
Stage Iii ◽  
Prognostic Models ◽  
Risk Scores ◽  
P Value ◽  
Prognostic Information

3509 Background: Prognosis prediction for resected primary colon cancer is currently based on the tumor, nodes, metastasis (TNM) staging system. Gene expression based risk scores have been proposed, but need to be validated and integrated with clinical and TNM variables. We performed an independent assessment of the individual recurrence signatures developed for commercial use by Veridex and Genomic Health. Methods: The Veridex (aVDS) and Genomic Health (aGHS) risk scores were applied to existing gene expression data of 580 stage III and 108 stage II tumors from the PETACC-3 trial. Association of the scores with relapse-free (RFS) and overall survival (OS) of the patients was assessed singularly, and in a combination with TNM and other clinico-pathological variables, by univariate and multivariate Cox regression models and logrank methods. Results: Both risk scores were significantly associated with RFS in univariate and multivariate models (Table) for the stage III cohort. The scores contributed different and additive prognostic information, and reached highest effect sizes (approximate p-value 0.001 and HR per interquartile range 1.4 each) in a combined model (Table) that includes both scores as well as T-stage, N-stage and MSI status as significant factors. Analysis in the stage II cohort gave similar effect estimates. Conclusions: This study confirms in an independent colon cancer patient cohort that gene expression based risk scores improve current prognostic models. The best prognostic model was obtained by using clinico-pathological variables and both gene-expression risk-scores. [Table: see text]

Transient increase in serum CEA while on adjuvant chemotherapy for colon cancer: Is this of prognostic importance?

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 654-654
Author(s):  
Nicola Jane Mitchell ◽  
Victoria Hinder ◽  
Melissa Murray ◽  
Jerome Macapagal ◽  
Paul Ivan Thompson ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Cox Regression ◽  
Transient Increase ◽  
Stage Ii ◽  
Response To Treatment ◽  
Metastatic Colon Cancer ◽  
Continuous Increase ◽  
Significant Difference ◽  
Serum Carcinoembryonic Antigen

654 Background: Serum Carcinoembryonic Antigen (CEA) is used to monitor response to treatment in metastatic colon cancer. Transient surges in CEA can occur after initiation of chemotherapy and are not associated with worse outcome. There is little data on transient CEA surge in the adjuvant setting. We aimed to review patterns of change in CEA levels with adjuvant chemotherapy and investigate associations between transient rises and patient survival. Methods: A retrospective review of patients in Auckland with a new diagnosis of colon cancer in 2001 or 2005 was reported previously [Murray, NZMJ, 2011]. CEA results immediately pre-chemotherapy, during and up to 9 months post chemotherapy were collected and death data was updated. Increase in CEA during chemotherapy was measured as the maximum change from baseline; values more than 2 (within-person) standard deviations above baseline [Erden, Scand, J Clin Lab Inv, 2008] were classified as increased. An increase was transient if the last recorded CEA post chemotherapy was within 2 sd of baseline. Three patient groups were defined: NI (no increase in CEA); TI (transient increase in CEA); and CI (continuous increase in CEA). Kaplan-Meier methods were used to estimate 5-year survival; Cox regression and log-rank p-values were used to compare survival. Results: Of the 77 patients identified with stage II or III disease who had received adjuvant chemotherapy, 61 had sufficient CEA data to be included. The TI group were younger (median [quartiles]: TI 59 [54, 64]; NI 65 [53, 74]; CI 68 [62, 74]) but a greater proportion were stage II (TI 32%; NI 23%; CI 17%). Patients were followed up for a minimum of 7.3 years (or death). Number of deaths per group were: TI 3/19; NI 9/30; CI 7/12. The 5 year overall survival was: TI 95%; NI 83%; CI 42%. There was no significant difference between TI and NI (p = 0.1), but the confidence interval was wide (HR 0.3; 95% CI (0.07 to 1.5). For CI compared to NI, the HR was 2.8 (95% CI (1.0 to 7.6), p = 0.04). Conclusions: The observation that CEA surge does not signal poorer prognosis will be further examined as part of a separate population-based New Zealand-wide study of colorectal cancer diagnosis, treatment and outcome. Part funded by a Genesis Oncology Trust grant.

Whole exome sequencing identifies novel prognostic biomarker in colon cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15098-e15098
Author(s):  
Yinchen Shen ◽  
Xiaohong Han ◽  
Zheng Wang ◽  
Dongge Liu ◽  
Yongkun Sun ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Prognostic Biomarker ◽  
Stage Ii ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Novel Gene ◽  
Colon Cancers ◽  
Whole Exome

e15098 Background: The incidence and mortality of cancer have been increasing in China, of which colorectal cancer (CRC) is ranking the fifth and among the leading cause of cancer-related deaths .Prognostic biomarker for colon cancer treated with standard adjuvant chemotherapy was rare and inconsistent, as gene mutations accumulation contribute to the carcinogenesis, available biomarkers may emerge by genome investigation. Methods: Whole exome sequencing was performed in 13 stage III colon cancers to identify gene alternations in patients with different outcomes, followed by 350 stage II-III colon cancers samples, of which clinicopathological characteristics and survival information were collected simultaneously to evaluate the clinical relevance in this cohort for evaluation of novel gene biomarkers. Results: Eight genes (CD97, ZNF568, WARS2, IL6R, APPL2, C9orf117, ANKRD32, ZNF443) were identified as differently expressed between two groups of good (DFS > 60 months) and poor (DFS < 25 month) separated according to treatment outcomes. ZNF443 was detected in 81.7% (286/350) samples, and ZNF443 (CA) was more common in male compared with female (56.0% vs 40.8%, P = 0.011).ZNF443 (CA) distribution differed related to different N stage, only stage N0 shared a higher frequency over 50% (P = 0.026).ANKRD32 was detected in 212 (93.8%) tumors, and ANKRD32 (CA) appeared more in left sites (included left colon and sigmoid colon, 61.1% vs 41.9%, P = 0.006). Moreover, ANKRD32 (CA) was significantly associated with superior disease-free survival (DFS) in stage III colon cancer patients (P = 0.044, HR 0.49, 95% CI0.24-0.98).Tumor nodal stage appeared as independent prognostic factor for DFS and over-all survival (OS) in stage II-III colon cancer (P < 0.05), and low tumor differentiation indicated a worse OS for colon cancers. While no other significant association was obtained between genes and survival in present study. Conclusions: Whole exome sequencing was efficient in discovering novel gene biomarkers in clinical evaluation. ANKRD32 was independently prognostic for DFS in stage III colon cancer.

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