Stratification of Stage II Colon Cancer Using Recurrence Prediction Value: A Multi-institutional International Retrospective Study

Shodai Mizuno; Kohei Shigeta; Yujin Kato; Jun Okui; Satoru Morita; Swati Sonal; Robert Goldstone; David Berger; Rama Al-Masri; Mahmoud Al-Masri; Yuki Tajima; Hiroto Kikuchi; Akira Hirata; Jumpei Nakadai; Hideo Baba; Kiyoaki Sugiura; Go Hoshino; Yuki Seo; Akitsugu Makino; Hirofumi Suzumura; Yoshiyuki Suzuki; Yoko Adachi; Takehiro Shimada; Takayuki Kondo; Shimpei Matsui; Ryo Seishima; Koji Okabayashi; Yuko Kitagawa; Hiroko Kunitake

doi:10.1097/SLA.0000000000006120

Stratification of Stage II Colon Cancer Using Recurrence Prediction Value: A Multi-institutional International Retrospective Study

Ann Surg. 2023 Oct 12. doi: 10.1097/SLA.0000000000006120. Online ahead of print.

Authors

Shodai Mizuno¹, Kohei Shigeta¹, Yujin Kato¹, Jun Okui^{1

2}, Satoru Morita¹, Swati Sonal³, Robert Goldstone³, David Berger³, Rama Al-Masri⁴, Mahmoud Al-Masri⁴, Yuki Tajima⁵, Hiroto Kikuchi⁵, Akira Hirata⁵, Jumpei Nakadai⁶, Hideo Baba⁶, Kiyoaki Sugiura⁷, Go Hoshino⁷, Yuki Seo⁷, Akitsugu Makino⁸, Hirofumi Suzumura⁸, Yoshiyuki Suzuki⁹, Yoko Adachi⁹, Takehiro Shimada⁹, Takayuki Kondo¹⁰, Shimpei Matsui¹, Ryo Seishima¹, Koji Okabayashi¹, Yuko Kitagawa¹, Hiroko Kunitake³

Affiliations

¹ Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
² Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.
³ General and Gastrointestinal Surgery, Massachusetts General Hospital, MA, USA.
⁴ Department of Surgery, King Hussein Cancer Center, Amman, Jordan.
⁵ Department of Surgery, Hiratsuka City Hospital, Kanagawa, Japan.
⁶ Department of Surgery, Saitama City Hospital, Saitama, Japan.
⁷ Department of Surgery, Japan Red Cross Ashikaga Hospital, Tochigi, Japan.
⁸ Department of Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
⁹ Department of Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
¹⁰ Department of Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan.

PMID: 37823278
DOI: 10.1097/SLA.0000000000006120

Abstract

Objective: To create a recurrence prediction value (RPV) of high-risk factor and identify the patients with high risk of cancer recurrence.

Summary background data: There are several high-risk factors known to lead to poor outcomes. Weighting each high-risk factor based on their association with increased risk of cancer recurrence can provide a more precise understanding of risk of recurrence.

Methods: We performed a multi-institutional international retrospective analysis of patients with Stage II colon cancer patients who underwent surgery from 2010 to 2020. Patient data from a multi-institutional database were used as the Training data, and data from a completely separate international database from two countries were used as the Validation data. The primary endpoint was recurrence-free survival (RFS).

Results: A total of 739 patients were included from Training data. To validate the feasibility of RPV, 467 patients were included from Validation data. Training data patients were divided into RPV low (n = 564) and RPV high (n = 175). Multivariate analysis revealed that risk of recurrence was significantly higher in the RPV high than the RPV low (Hazard ratio (HR) 2.628; 95% confidence interval (CI) 1.887-3.660; P < 0.001). Validation data patients were divided into two groups (RPV low, n = 420) and RPV high (n = 47). Multivariate analysis revealed that risk of recurrence was significantly higher in the RPV high than the RPV low (HR 3.053; 95% CI 1.962-4.750; P < 0.001).

Conclusions: RPV can identify Stage II colon cancer patients with high risk of cancer recurrence world-wide.