title: Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort.
abstract: BACKGROUND
  The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients.
  
  
  METHODS
  A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves.
  
  
  RESULTS
  High miRNA-21 expression was associated with an unfavourable recurrence-free cancer-specific survival (RF-CSS), hazard ratio 1.35 (95% confidence interval, 1.03-1.76) (P=0.028). The generated RF-CSS index divided the traditional high-risk patients into subgroups with 5-year RF-CSS rates of 87% and 73%, respectively (P<0.001). The overall survival (OS) index identified three different subgroups (P<0.001). Cross-validated 5-year OS rates were 88%, 68%, and 50%, respectively.
  
  
  CONCLUSIONS
  This population-based study supports miRNA-21 as an additional prognostic biomarker in patients with stage II colon cancer. Furthermore, the introduction of a risk index may guide the use of postoperative adjuvant treatment in a more appropriate way compared with current practice.
authors: 1] Department of Oncology, Vejle Hospital, part of Lillebaelt Hospital, Kabbeltoft 25, 7100 Vejle, Denmark [2] Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
authors: T F
authors: TF
authors: Hansen
authors: 1] Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark [2] Department of Clinical Pathology, Vejle Hospital, part of Lillebaelt Hospital, Vejle, Denmark.
authors: S
authors: S
authors: Kjær-Frifeldt
authors: Research Unit of General Practice Odense, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
authors: R D
authors: RD
authors: Christensen
authors: Exiqon A/S, Vedbæk, Denmark.
authors: S
authors: S
authors: Morgenthaler
authors: Exiqon A/S, Vedbæk, Denmark.
authors: T
authors: T
authors: Blondal
authors: Department of Clinical Pathology, Vejle Hospital, part of Lillebaelt Hospital, Vejle, Denmark.
authors: J
authors: J
authors: Lindebjerg
authors: 1] Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark [2] Department of Clinical Pathology, Vejle Hospital, part of Lillebaelt Hospital, Vejle, Denmark.
authors: F B
authors: FB
authors: Sørensen
authors: 1] Department of Oncology, Vejle Hospital, part of Lillebaelt Hospital, Kabbeltoft 25, 7100 Vejle, Denmark [2] Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.
authors: A
authors: A
authors: Jakobsen
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D003110:Colonic Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D015870:Gene Expression; D006801:Humans; D008297:Male; D035683:MicroRNAs / Q000235:genetics / Q000378:metabolism*; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D012306:Risk
chemical_list: D014408:Biomarkers, Tumor; C524940:MIRN21 microRNA, human; D035683:MicroRNAs