Clinicopathological and Molecular Characteristics of Early-Onset Stage III Colon Adenocarcinoma: An Analysis of the ACCENT Database

Author:

Jin Zhaohui1ORCID,Dixon Jesse G2ORCID,Fiskum Jack M2,Parekh Hiral D3,Sinicrope Frank A1,Yothers Greg4ORCID,Allegra Carmen J5,Wolmark Norman6,Haller Daniel7ORCID,Schmoll Hans-Joachim8,de Gramont Aimery9,Kerr Rachel10ORCID,Taieb Julien11ORCID,Van Cutsem Eric12,Tweleves Christopher13ORCID,O’Connell Michael1,Saltz Leonard B1ORCID,Sadahiro Sotaro14,Blanke Charles D15ORCID,Tomita Naohiro16,Seitz Jean-Francois17,Erlichman Charles1ORCID,Yoshino Takayuki18,Yamanaka Takeharu19,Marsoni Silvia20ORCID,Andre Thierry21ORCID,Mahipal Amit1ORCID,Goldberg Richard M22ORCID,George Thomas J23ORCID,Shi Qian2ORCID

Affiliation:

1. Department of Oncology, Mayo Clinic, Rochester, MN, USA

2. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA

3. Cancer Specialists of North Florida, Jacksonville, FL, USA

4. Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA

5. Department of Medicine, Shands Cancer Center, University of Florida, Gainesville, FL, USA

6. University of Pittsburgh, Pittsburgh, PA, USA

7. Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

8. Department of Internal Medicine IV-Hematology-Oncology, University Clinic Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Germany

9. Department of Medical Oncology, Franco-British Institute, Levallois-Perret, France

10. University of Oxford, Oxford, UK

11. Sorbonne Paris Cité, Paris Descartes University Georges Pompidou European Hospital, Paris, France

12. Digestive Oncology, University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium

13. University of Leeds and St. James’s Institute of Oncology, Tom Connors Cancer Research Center, University of Bradford, Bradford, UK

14. Department of Surgery, Tokai University, Tokyo, Japan

15. Oregon Health and Science University, Portland, OR, USA

16. Cancer Treatment Center, Toyonaka Municipal Hospital, Toyonaka, Japan

17. Hôpital La Timone, Marseille, France

18. Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan

19. Department of Biostatistics, Yokohama City University School of Medicine, Kanagawa, Japan

20. FIRC Institute of Molecular Oncology, Milan, Italy

21. Medical Oncology Department in St. Antoine Hospital, Assistance Publique Hôpitaux de Paris, Paris, France

22. West Virginia University Cancer Institute and the Mary Babb Randolph Cancer Center, Morgantown, WV, USA

23. University of Florida, Health Cancer Center, Gainesville, FL, USA

Abstract

Abstract Background Colon cancer (CC) incidence in young adults (age 20-49 years), termed early-onset CC (EO-CC), is increasing. Methods Individual patient data on 35 713 subjects with stage III colon cancer from 25 randomized studies in the Adjuvant Colon Cancer ENdpoint database were pooled. The distributions of demographics, clinicopathological features, biomarker status, and outcome data were summarized by age group. Overall survival, disease-free survival, time to recurrence, and survival after recurrence were assessed by Kaplan-Meier curves and Cox models stratified by treatment arms within studies, adjusting for sex, race, body mass index, performance status, disease stage, grade, risk group, number of lymph nodes examined, disease sidedness, and molecular markers. All statistical tests were 2-sided. Results Using a 5% difference between age groups as the clinically meaningful cutoff, patients with stage III EO-CC had similar sex, race, performance status, risk group, tumor sidedness, and T stage compared with patients with late-onset CC (age 50 years and older). EO-CC patients were less likely to be overweight (30.2% vs 36.2%) and more commonly had 12 or more lymph nodes resected (69.5% vs 58.7%). EO-CC tumors were more frequently mismatch repair deficient (16.4% vs 11.5%) and less likely to have BRAFV600E (5.6% vs 14.0%), suggesting a higher rate of Lynch syndrome in EO-CC. Patients with EO-CC had statistically significantly better overall survival (hazard ratio [HR] = 0.81, 95% confidence interval [CI] = 0.74 to 0.89; P < .001), disease-free survival (HR = 0.91, 95% CI = 0.84 to 0.98; P = .01), and survival after recurrence (HR = 0.88, 95% CI = 0.80 to 0.97; P = .008) in the analysis without molecular markers; however, age at onset of CC lost its prognostic value when outcome was adjusted for molecular markers. Conclusion Tumor biology was found to be a more important prognostic factor than age of onset among stage III colon cancer patients in the Adjuvant Colon Cancer ENdpoint database.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

Reference45 articles.

1. Cancer statistics, 2020;Siegel;CA A Cancer J Clin,2020

2. Colorectal cancer statistics, 2020;Siegel;CA A Cancer J Clin,2020

3. Colorectal cancer in the young: epidemiology, prevention, management;Siegel;Am Soc Clin Oncol Educ Book,2020

4. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths;Siegel;CA Cancer J Clin,2011

5. Cancer statistics, 2019;Siegel;CA A Cancer J Clin,2019

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3