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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1402847
This article is part of the Research Topic Understanding Molecular Mechanisms to Facilitate the Development of Biomarkers for Therapeutic Intervention in Gastrointestinal Diseases and Sepsis View all 8 articles

Development and validation of nomograms based on pre-/postoperative CEA and CA19-9 for survival predicting in stage I-III colorectal cancer patients after radical resection

Provisionally accepted
Xuan Dai Xuan Dai 1Yifan Li Yifan Li 2Haoran Wang Haoran Wang 3Zhujiang Dai Zhujiang Dai 1Yuanyuan Chen Yuanyuan Chen 1Yun Liu Yun Liu 1*Shiyong Huang Shiyong Huang 1*
  • 1 Department of Colorectal and Anal Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  • 2 Department of Gastroenterology, Huaihe Hospital, Henan University, Kaifeng, Henan Province, China
  • 3 Xinxiang Medical University, Xinxiang, Henan Province, China

The final, formatted version of the article will be published soon.

    Background: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are the predominant serum tumour markers(STMs) for predicting the prognosis of colorectal cancer (CRC). The objective of this research is to develop clinical prediction models based on preoperative and postoperative CEA and CA19-9 levels. Methods: 1,452 consecutive participants with stage I-III colorectal cancer were included. Kaplan-Meier method, log-rank test, and multivariate COX regression were used to evaluate the significance of preoperative and postoperative STMs. Patients were grouped into a discovery cohort (70%) and a validation cohort (30%). Variables for the nomograms were selected according to the Akaike information criterion (AIC). Subsequently, two clinical predictive models were constructed, evaluated, validated, and then compared with the AJCC 8th TNM stage. Results: The overall survival(OS) rate and disease-free survival(DFS) rate declined progressively as the number of positive tumour markers(NPTMs) before and after surgery increased. For both OS and DFS, age, sex, pN stage, and NPTMs before and after surgery were independent prognostic factors, and then clinical prediction models were developed. The Concordance index (C-index), Receiver operating characteristic (ROC) curve, calibration curve, Decision curve analysis(DCA), and risk score stratification all indicated that the models possessed robust predictive efficacy and clinical applicability. The Net reclassification index(NRI) and Integrated discrimination improvement(IDI) indicated that the performance of models was significantly superior to the TNM stage. Conclusion: Nomograms based on pre-and postoperative CEA and CA19-9 can accurately predict survival and recurrence for stage I-III CRC patients after radical surgery, and were significantly better than the AJCC 8th TNM stage.

    Keywords: CEA, CA19-9, nomogram, colorectal cancer, overall survival, Disease-Free Survival

    Received: 18 Mar 2024; Accepted: 24 Sep 2024.

    Copyright: © 2024 Dai, Li, Wang, Dai, Chen, Liu and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yun Liu, Department of Colorectal and Anal Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
    Shiyong Huang, Department of Colorectal and Anal Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China

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