Prognostic impact of CDX2 in stage II colon cancer: results from two nationwide cohorts

Background The aim of the present study was to validate the prognostic impact of CDX2 in patients with stage II colon cancer. Methods Two unbiased population-based cohorts representing all patients operated for stage II colon cancer in Denmark in 2002 and 2003. The CDX2 expression was evaluated by i...

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Bibliographic Details
Published in:British journal of cancer 2018-11, Vol.119 (11), p.1367-1373
Main Authors: Hansen, Torben Frøstrup, Kjær-Frifeldt, Sanne, Eriksen, Ann Christina, Lindebjerg, Jan, Jensen, Lars Henrik, Sørensen, Flemming Brandt, Jakobsen, Anders
Format: Article
Language:English
Subjects:
Aged
Biomedical and Life Sciences
Biomedicine
Cancer Research
CDX2 protein
CDX2 Transcription Factor - genetics
CDX2 Transcription Factor - metabolism
Cohort Studies
Colon cancer
Colonic Neoplasms - epidemiology
Colonic Neoplasms - metabolism
Colonic Neoplasms - pathology
Colorectal cancer
Denmark - epidemiology
Drug Resistance
Epidemiology
Female
Humans
Immunohistochemistry
Male
Medical prognosis
Middle Aged
Molecular Medicine
Oncology
Prognosis
Recurrence
Registries
Regression analysis
Reproducibility of Results
Survival
Tumors
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Summary:Background The aim of the present study was to validate the prognostic impact of CDX2 in patients with stage II colon cancer. Methods Two unbiased population-based cohorts representing all patients operated for stage II colon cancer in Denmark in 2002 and 2003. The CDX2 expression was evaluated by immunohistochemistry on whole tumour sections. Patients were classified into three groups, CDX2-positive, -moderate, and -negative, for comparison with the clinical data. Results A total of 1157 patients were included. We found a significant relationship between loss of CDX2 expression and poor disease-free survival in both cohorts, p  = 0.0267 and 0.0118, respectively. Five-year disease-free survival rates were 66%, 72% and 74% in the first cohort and 62%, 65%, and 75% in the second cohort for the negative, moderate, and positive CDX2 expression groups, respectively. Multiple Cox regression analysis performed on the combined cohorts confirmed an independent prognostic impact of CDX2 on disease-free survival, hazard ratio 1.543 (95% confidence interval 1.129–2.108), p  = 0.0065. Conclusions This retrospective study provides validation regarding the prognostic impact of CDX2 in patients with stage II colon cancer. The results justify prospective validation clarifying its clinical impact.
ISSN:0007-0920
1532-1827
DOI:10.1038/s41416-018-0285-5