scholarly journals Prognostic Significance of Lymphovascular Invasion Detected by D2-40 in Low-Risk Stage II Colon Cancer

Cureus ◽  
2021 ◽  
Author(s):  
Anand Prugmahachaikul ◽  
Anapat Sanpavat
Keyword(s):  
Colon Cancer ◽  
Lymphovascular Invasion ◽  
Prognostic Significance ◽  
Low Risk ◽  
Stage Ii ◽  
Stage Ii Colon Cancer

The PARSC trial, a prospective study for the assessment of recurrence risk in stage II colon cancer (CC) patients using ColoPrint.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 678-678 ◽  
Author(s):  
Ramon Salazar ◽  
Jan Willem de Waard ◽  
Bengt Glimelius ◽  
John Marshall ◽  
Joost Klaase ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Colon Cancer ◽  
High Risk ◽  
Prospective Study ◽  
Relapse Rate ◽  
Recurrence Risk ◽  
Low Risk ◽  
Stage Ii ◽  
Risk Patients ◽  
Stage Ii Colon Cancer

678 Background: An 18-gene expression profile, ColoPrint, has been developed for identifying CC patients more likely to develop recurrent disease and who would be candidates for adjuvant chemotherapy. The gene signature was validated in in-silico datasets and independent patient cohorts of stage II and III patients. Uni-and multivariate analysis was performed on the pooled stage II patient set (n=320) who had a median follow-up of 70 months. ColoPrint identified two-third of the stage II patients (209/320) as low risk. The 3-year relapse-free survival was 94% for Low Risk patients and 79% for High Risk patients with a HR of 2.74 (95% CI 1.54 - 4.88; p=0.006). Moreover, the profile stratified patients independent of ASCO clinical risk factors. Methods: A prospective trial, PARSC (Prospective study for the Assessment of Recurrence risk in Stage II CC patients) using ColoPrint has been initiated. Objectives are: (1) to validate the performance of ColoPrint in estimating the 3-year relapse rate in patients with stage II colon cancer; (2) to compare the risk assessment in stage II patients using the ColoPrint profile vs. a clinical risk assessment based on Investigator’s assessment of risk and ASCO high-risk recommendations; (3) to investigate therapy as a potential confounding factor for ColoPrint results; and (4) to assess the performance of ColoPrint in estimating the 3-year relapse rate in patients with stage III colon cancer. Inclusion criteria: age ≥ 18 years, adenocarcinoma of the colon, stage II and III, no prior neo-adjuvant therapy, no synchronous tumors, fresh tumor sample, and written informed consent. The treatment of the patient is at the discretion of the physician adhering to National Comprehensive Cancer Network (NCCN)-approved regimens or a recognized alternative. Results: The trial started in Sept. 2008 with currently 30 participating sites in 11 countries. Thus far, 288 eligible stage 2 and 251 stage 3 patients have been enrolled. Conclusions: The aim is to enroll 575 stage II patients to differentiate between 3 year RFS predicted by ColoPrint and clinical factors.

scholarly journals Effect of adjuvant chemotherapy on stage II colon cancer: Analysis of Korean national data.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 798-798
Author(s):  
Minki KIM ◽  
Daeyoun Won ◽  
Seong Taek Oh ◽  
In Kyu Lee
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Quality Assessment ◽  
Cancer Patients ◽  
Risk Group ◽  
Low Risk ◽  
Stage Ii ◽  
Current Status ◽  
National Quality ◽  
Stage Ii Colon Cancer

798 Background: Debates exist regarding the effectiveness of adjuvant chemotherapy for stage II colon cancer. This study aimed to investigate the current status of adjuvant chemotherapy and its impact on survival for Korean stage II colon cancer patients by analyzing the National Quality Assessment data. Methods: A total of 7880 patients who underwent curative resection for stage II colon adenocarcinoma between Jan 2011 and Dec 2014 in Korea were selected randomly as evaluation subjects for the quality assessment. The factors that influenced overall survival were identified. The high-risk group was defined as having at least one of the following: perforation/obstruction, lymph node harvest less than 12, lymphovascular/perineural invasion, positive resection margin, poor differentiation, or pathologic T4 stage. Results: The median follow-up period was 38 (1-63) months. Chemotherapy was a favorable prognostic factor for either the high- (HR 0.50 [0.40-0.62], p < 0.001) or low-risk group (HR 0.74 [0.61-0.89], p = 0.002) in multivariate analysis. This was also the case in patients over 70 years of age. The hazard ratio was significantly increased as the number of involved risk factors was increased in patients who didn’t receive chemotherapy. However, there was no survival difference between low-risk group patients and patients who only had 1 risk factor among patients who received adjuvant chemotherapy (HR 1.19 [0.93-1.52], p = 0.165). Adding oxaliplatin showed no difference in survival (HR 1.36 [0.91-2.03], p = 0.132). Conclusions: Adjuvant chemotherapy can be recommended for stage II colon cancer patients, but the addition of oxaliplatin to the regimen must be selective.

Presence of 18q loss of heterozygosity (LOH) and disease-free and overall survival in stage II colon cancer: CALGB Protocol 9581

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4012-4012 ◽  
Author(s):  
M. M. Bertagnolli ◽  
D. Niedzwiecki ◽  
M. Hall ◽  
S. D. Jewell ◽  
R. J. Mayer ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Performance Status ◽  
Disease Free Survival ◽  
Patient Characteristics ◽  
Low Risk ◽  
Stage Ii ◽  
Assay Method ◽  
Stage Ii Colon Cancer ◽  
Disease Free

4012 Background: LOH at 18q is associated with poorer overall survival in patients with colon cancer; however available studies are retrospective and vary in analysis methods. We recently completed an 18qLOH assay method validation study, and after standardizing technique, this prospective study investigated the role of 18qLOH among patients with low-risk stage II colon cancer. Methods: In Cancer and Leukemia Group B (CALGB) protocol 9581, we randomized 1738 stage II patients to post-operative treatment with a 500 mg loading dose of monoclonal antibody 17–1A followed by four infusions of 100 mg every 28 days or observation. The primary endpoint was overall survival (OS); disease free survival (DFS) was a secondary endpoint. Status of 18qLOH was assessed in patients with available tissue and interpretable PCR results. Patients were excluded if their tumors were uninformative for 18qLOH or if their tumors displayed microsatellite instability. Results: We report 18qLOH data on 156 patients. Patient characteristics including treatment, age, gender, performance status, site and grade of tumor, were similar between all patients enrolled and the subset of patients with tumor samples analyzed. The DFS and OS for treated and observed patients were no different (5-yr DFS: 0.81 and 0.80, p= 0.96; 5-yr OS: 0.88 and 0.86, p=0.44 at a median of 6.8 yrs of follow-up) and the data were pooled across the study's arms. Of the tumors examined, 101 (65%) were positive for 18qLOH. A significantly lower proportion of patients with 18qLOH-positive tumors had proximal tumors (46.5% vs 65.5%; p=0.02). Significantly decreased DFS and OS were observed in patients with 18qLOH-positive tumors. Five-year DFS among patients with 18qLOH-positive tumors was 0.78 vs 0.93 among patients with 18qLOH-negative tumors [HR 0.39; 95% CI (0.16, 0.94); logrank p=0.03 based on 33 events]. Five-year OS among patients with 18qLOH-positive tumors was 0.85 vs 0.98 among patients with 18qLOH-negative tumors [HR 0.25; 95% CI (0.07, 0.83); logrank p=0.01 based on 24 events]. Conclusions LOH at 18q was prognostic for DFS and OS among patients with available tissue for analysis after resection of low-risk stage II colon cancer who were not treated with chemotherapy in the adjuvant setting. [Table: see text]

Contribution of tumor stroma ratio to a better selection of stage II colon cancer patients into high and low risk groups: A population based study.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 3582-3582
Author(s):  
Sanne Kjaer-Frifeldt ◽  
Gabi W. van Pelt ◽  
Rene dePont Christensen ◽  
Wilma E Mesker ◽  
Anders Kristian Moeller Jakobsen ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Tumor Stroma ◽  
Risk Groups ◽  
Population Based ◽  
Low Risk ◽  
Stage Ii ◽  
Population Based Study ◽  
Stage Ii Colon Cancer ◽  
Selection Of

scholarly journals Adjuvant chemotherapy use and outcomes of patients with high-risk versus low-risk stage II colon cancer

Cancer ◽  
2014 ◽  
Vol 121 (4) ◽  
pp. 527-534 ◽  
Author(s):  
Aalok Kumar ◽  
Hagen F. Kennecke ◽  
Daniel J. Renouf ◽  
Howard J. Lim ◽  
Sharlene Gill ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Low Risk ◽  
Stage Ii ◽  
Stage Ii Colon Cancer

scholarly journals Adjuvant chemotherapy with tegafur/uracil for more than 1 year improves disease-free survival for low-risk Stage II colon cancer

2016 ◽  
Vol 79 (9) ◽  
pp. 477-488 ◽  
Author(s):  
Je-Ming Hu ◽  
Yu-Ching Chou ◽  
Chang-Chieh Wu ◽  
Cheng-Wen Hsiao ◽  
Chia-Cheng Lee ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Low Risk ◽  
Stage Ii ◽  
Free Survival ◽  
Stage Ii Colon Cancer ◽  
Disease Free

Population based study of prognostic factors in stage II colon cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3619-3619
Author(s):  
M. J. Morris ◽  
B. Iacopetta ◽  
C. Platell
Keyword(s):  
Colon Cancer ◽  
Prognostic Factors ◽  
Vascular Invasion ◽  
Poor Prognosis ◽  
Prognostic Significance ◽  
Population Based ◽  
Stage Ii ◽  
Prognosis Group ◽  
Stage Ii Colon Cancer

3619 Background: Guidelines for the use of adjuvant chemotherapy in stage II colorectal cancer state this treatment may be considered to patients whose tumours show features of poor prognosis. The aim of the current study was to evaluate the prognostic significance of commonly reported clinical and pathological features of this disease. Methods: A population-based observational study encompassing all stage II colon cancer patients diagnosed in the state of Western Australia from 1993–2003 inclusive. A total of 1306 cases treated by surgery alone were identified and had a median follow-up of 59 months (range 0–145). Results: Multivariate analysis revealed the only independent prognostic factors for disease-specific survival were T4 stage (HR=1.75, 95%CI [1.32–2.32], P<0.0001) and vascular invasion (HR=1.63, 95%CI [1.15–2.30], P<0.0001). In the younger patient group (≤75 yrs) who are more likely to be considered for chemotherapy, the same two features showed independent prognostic significance but with higher HR values (1.96 and 2.73 respectively). T4 and/or the presence of vascular invasion identified a “poor” prognosis group comprising 26% of younger cases and having a 5-year survival rate of 71%. The remaining “good” prognosis group showed 84% survival at 5 years follow-up. Conclusion: This study highlights the importance of accurate pathological assessment of T stage and vascular invasion for the prognostic stratification of stage II colon cancer and their subsequent consideration for adjuvant chemotherapy. No significant financial relationships to disclose.

Clinical and technical validation of a genomic classifier (ColoPrint) for predicting outcome of patients with stage II colon cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 384-384 ◽  
Author(s):  
Josep Tabernero ◽  
Victor Moreno ◽  
Robert Rosenberg ◽  
Ulrich Nitsche ◽  
Thomas Bachleitner-Hofmann ◽  
...  
Keyword(s):  
Gene Expression ◽  
Colon Cancer ◽  
Multivariate Analysis ◽  
High Risk ◽  
Low Risk ◽  
Stage Ii ◽  
Clinical Parameters ◽  
Risk Patients ◽  
Stage Ii Colon Cancer

384 Background: Between 25 and 35% of stage II colon cancer patients will experience a relapse of their disease and may benefit from adjuvant chemotherapy. ColoPrint is a gene expression classifier that can predict disease relapse in patients with early-stage colorectal cancer (Salazar et al. JCO 2011). Methods: ColoPrint was developed using gene expression data from whole genome microarrays and was validated in in-silico datasets and independent patient cohorts from 5 European hospitals. Fresh frozen tissues, clinical parameters, MSI-status and follow-up data for patients were available. Samples were hybridized to Agilent microarrays and the ColoPrint index was determined. Uni-and multivariate analysis was performed on the pooled stage II patient set (n=320) who had a median follow-up of 70 months. Reproducibility and precision studies were performed using clinical and control samples specific for each outcome level (high risk, low risk). Experiments were performed on 20 days with 2 runs per day by multiple technicians reflecting daily diagnostic conditions. Results: Performance of the prognostic classifier was confirmed in reproducibility and stability assays and stringent quality controls were established. In the clinical validation, ColoPrint classified two-third of patients (209/320) as low risk. The 3-year relapse-free survival was 94% for low risk patients and 79% for high risk patients with a HR of 2.74 (95% CI 1.54-4.88; p=0.006). MSI-status and the number of assessed lymph nodes were the only significant clinical parameters in the univariate analysis. Using parameters from the ASCO recommendation (T4, perforation, less than 12 LN assessed and/ or high grade) for the identification of high risk patients was not significant (HR 1.43, 95% CI 0.81-2.55; p= 0.22) and no clinical parameter added power to the ColoPrint classification in multivariate analysis. Conclusions: ColoPrint is available as a routine diagnostic test with a high precision and reproducibility. ColoPrint significantly improves the prognostic accuracy of pathologic factors and MSI and facilitates the identification of low risk patients with stage II disease who may be safely managed without chemotherapy.

The PARSC trial, a prospective study for the assessment of recurrence risk in stage II colon cancer patients using ColoPrint.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. TPS10632-TPS10632
Author(s):  
Ramon Salazar ◽  
John Marshall ◽  
Jaume Capdevila ◽  
Bengt Glimelius ◽  
Jan Willem de Waard ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Colon Cancer ◽  
High Risk ◽  
Prospective Study ◽  
Cancer Patients ◽  
Relapse Rate ◽  
Recurrence Risk ◽  
Low Risk ◽  
Stage Ii ◽  
Stage Ii Colon Cancer

TPS10632 Background: An 18-gene expression profile, ColoPrint, has been developed for identifying colon cancer patients more likely to develop recurrent disease and who would be candidates for adjuvant chemotherapy. The gene signature was validated in public datasets and independent patient cohorts (stage II and III patients). Uni-and multivariate analysis was performed on the pooled stage II patient set (n=320) (median follow-up 70 months). ColoPrint classifies 65% of stage II patients as Low Risk. The 3-year RFS was 91% for Low Risk and 74% for High Risk patients with a HR of 2.9 (p=0.001). ColoPrint was the only significant prognostic marker in the subgroup of patients with T3-MSS phenotype (Tabernero, ASCO GI 2012). Methods: A blinded prospective trial, PARSC (Prospective study for the Assessment of Recurrence risk in Stage II colon cancer patients) using ColoPrint has been initiated. Objectives are: (1)To validate the performance of ColoPrint in estimating the 3-year relapse rate in patients with stage II colon cancer. (2) To compare the risk assessment in stage II patients using the ColoPrint profile vs a clinical risk assessment based on Investigator’s assessment of risk and ASCO high-risk recommendations. (3) To investigate therapy as a potential confounding factor for ColoPrint results. (4) To assess the performance of ColoPrint in estimating the 3-year relapse rate in patients with stage III colon cancer. Inclusion criteria: age ≥ 18 years, adenocarcinoma of the colon, stage II and III, no prior neo-adjuvant therapy, no synchronous tumors, fresh tumor sample, and written informed consent. The treatment of the patient is at the discretion of the physician adhering to National Comprehensive Cancer Network (NCCN)-approved regimens or a recognized alternative (blinded for ColoPrint result). The trial started in Sept. 2008 with currently 32 participating sites in 11 countries. Thus far, 340 eligible stage II and 280 stage III patients have been enrolled. The aim is to enroll 575 stage II patients. Clinical trial registry number: NCT00903565.

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