Lower serum CA125 level, negative vascular invasion, and wild BRAF were strongly associated with better 2-year disease-free survival in patients with stage III colorectal cancer who received adjuvant chemotherapy

Article type: Research Article

Authors: Chang, Shu-Jian^{a; *} | Ge, Xiao-Song^a | Xu, Zhen-Yu^a | Qi, Xiao-Wei^b | Chen, Xiao-Ping^a

Affiliations: [a] Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu, China | [b] Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi 214062, Jiangsu, China

Correspondence: [*] Corresponding author: Shu-Jian Chang, Department of Oncology, Affiliated Hospital of Jiangnan University (Wuxi No. 4 Hospital), Wuxi 214062, Jiangsu, China. Tel.: +86 18861530277; E-mail: [email protected].

Abstract: BACKGROUND: Adjuvant chemotherapy plays important role in the comprehensive treatment of patients with stage III colorectal cancer. However, there is few molecular markers for predicting the therapeutic effect. OBJECTIVE:To identify factors that could predict adjuvant chemotherapy benefits in patients with stage III colorectal cancer. Methods:The medical records of 294 patients were reviewed and analyzed using the Kaplan–Meier method and Cox analysis. RESULTS: Lower CA125 (⩽ 35 u/ml, P= 0.0015) serum levels, stage IIIa (P= 0.0027), 1-3 positive lymph nodes (P= 0.0256), negative vascular invasion (P= 0.0215), lower CA199 (⩽ 27 u/ml, P= 0.0038) serum levels, and wild-type BRAF status (P= 0.0125) were significantly associated with a higher 2-year DFS rate in patients with stage III colorectal cancer. However, in multivariate COX analysis, the association remained significant only for CA125 levels (vs. ⩽ 35 u/ml group, HR 3.341; 95% CI, 1.198–9.316; P= 0.0212), vascular invasion (vs. negative vascular invasion, HR, 2.349; 95% CI, 1.227–4.499; P= 0.01), and BRAF (V600E) (vs. wild Braf, HR, 7.794; 95% CI, 1.867–32.531; P= 0.0049). CONCLUSION:Lower CA125 serum levels, negative vascular invasion, and wild-type BRAF status were significantly associated with improved 2-year DFS rates among patient with stage III disease who received adjuvant chemotherapy.

Keywords: CA125, vascular invasion, BRAF, adjuvant chemotherapy, colorectal cancer

DOI: 10.3233/CBM-181179

Journal: Cancer Biomarkers, vol. 22, no. 1, pp. 161-168, 2018