A prediction model for risk factors of stage II to III colon cancer based on postoperative serum carcinoembryonic antigen and tumor deposition: a retrospective multicenter cohort study

Abstract Purpose: This study aimed to establish a recurrence risk prediction model composed of postoperative CEA combined with pathological features for postoperative recurrence risk stratification in stage II to III colon cancer. Methods: A retrospective analysis of 1,321 patients who underwent radical surgery for stage II/III colon cancer from April 2008 to January 2019. Cox proportional hazards regression model was used to analyze the independent recurrence prognostic factors of patients with recurrence-free survival (RFS). The recurrence risk score was established based on independent recurrence prognostic factors, and the Kaplan-Meier method was used to draw the patient's recurrence-free survival curve and overall survival (OS) curve.Results: The median follow-up period of all patients was 49.73 months. Multivariate analysis of COX proportional hazards model showed that postoperative CEA increased (HR, 2.0; 95% CI, 1.1-3.5), higher stage N (HR, 2.0; 95 % CI, 1.1-3.5), tumor deposition (HR, 2.0; 95% CI, 1.1-3.5) is independently associated with shorter RFS. The recurrence risk score is an independent stratified prognostic factor of RFS and OS.Conclusion: Based on postoperative CEA, N stage and tumor deposition positive are powerful predictors of recurrence survival and prognosis for patients with stage II to III colon cancer.