Cell-to-cell adhesion and angiogenesis are hallmarks of cancer. No studies have examined associations of adhesion-molecules and angiogenesis biomarkers with clinical outcomes in colorectal cancer (CRC).
In pre-surgery serum from n=426 CRC patients (stage I-III) we investigated associations of CRP, SAA, adhesion molecules (sICAM-1, sVCAM-1), and angiogenesis markers (VEGF-A, and -D) with overall survival (OS), disease-free survival (DFS), and risk of recurrence. We computed hazard ratios (HR) and 95% confidence intervals; adjusted for age, sex, BMI, stage, site, and study site, stratified by tumor site in exploratory analyses.
N=65 (15%) were deceased, 59 patients (14%) had a recurrence after a median follow-up of 31 months. We observed significant associations of biomarkers with OS, DFS, and risk of recurrence on a continuous scale and comparing top to bottom tertile, with HRs ranging between 1.19 - 13.92. CRP was associated with risk of death and recurrence in patients in the top tertile compared to patients in the bottom tertile, e.g., risk of recurrence HRQ3-Q1:13.92 (1.72, 112.56). Significant heterogeneity between biomarkers and clinical outcomes was observed in stratified analysis by tumor site for CRP, SAA, sICAM-1, sVCAM-1, and VEGF-D. VEGF-D was associated with a 3-fold increase in risk of death for rectal cancer (HRlog2: 3.26; 95% CI: 1.58-6.70) compared to no association for colon cancer (HRlog2: 0.78; 95% CI: 0.35-1.73; pheterogenity =0.01).
Adhesion molecules and angiogenesis biomarkers are independent prognostic markers for CRC, with differences by tumor site.
There is need for tailored treatment for colon and rectal cancer.