title: Prognostic Value of Molecular Detection of Lymph Node Metastases After Curative Resection of Stage II Colon Cancer: A Systematic Pooled Data Analysis.
abstract: BACKGROUND
  We aimed to clarify the prognostic value of guanylyl cyclase C (GCC) lymph node ratio (LNR) status as a predictor of recurrence in untreated stage IIA colon cancer on the basis of pooled individual data from previous studies.
  
  
  METHODS
  Patients were classified according to predefined GCC LNR risk groups (low, LNR ≤ 0.1; intermediate, 0.1 < LNR ≤ 0.2; high, LNR > 0.2). Outcomes included time to recurrence, disease-free survival, and overall survival. Stratified log-rank tests and multivariate Cox models assessed the association between outcomes and GCC lymph node status.
  
  
  RESULTS
  The final data set contained 553 patients with stage IIA colon cancer with a median of 18 lymph nodes examined after resection; 65 patients (11.8%) had recurrence. Overall, 109 patients (19.7%) were classified high risk on the basis of GCC LNR. In multivariate analysis, high GCC LNR value (> 0.2) was a significant predictor of cancer recurrence (hazard ratio [HR], 3.18; 95% confidence interval [CI], 1.77-5.71; P < .001) and lower disease-free survival (HR, 2.40; 95% CI, 1.60-3.62; P < .001) and overall survival (HR, 2.12; 95% CI, 1.35-3.33; P = .001).
  
  
  CONCLUSIONS
  Patients considered at high risk on the basis of their GCC LNR status have significantly inferior outcomes compared to those with low GCC LNR values, particularly among those traditionally considered to be at low risk for recurrence.
authors.affiliation: University of British Columbia, BC Cancer Agency, Vancouver, BC, Canada. Electronic address: sgill@bccancer.bc.ca.
authors.forename: Sharlene
authors.initials: S
authors.lastname: Gill
authors.affiliation: DiagnoCure Inc, Québec, QC, Canada.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Haince
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Qian
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Pavey
authors.affiliation: DiagnoCure Inc, Québec, QC, Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Beaudry
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sargent
authors.affiliation: DiagnoCure Inc, Québec, QC, Canada.
authors.forename: Yves
authors.initials: Y
authors.lastname: Fradet
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics; D003110:Colonic Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled / Q000235:genetics; D018000:Receptors, Peptide / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D012333:RNA, Messenger; D018000:Receptors, Peptide; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled
keywords: Colon cancer; Guanylyl cyclase-C receptor; Lymph node ratio; Molecular staging; Prognosis