ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
A large-scale study integrating CEA and tumor deposits to evaluate prognosis in colon cancer patients
Provisionally accepted
- Hebei General Hospital, Shijiazhuang, China
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Abstract Background: Reliable prediction of long-term survival in colon cancer remains limited by staging system constraints. CEA and tumor deposits (TD) are known prognostic markers, but their combined predictive value is underexplored. Materials and Methods: We retrospectively analyzed 1,029 patients with locally advanced colon cancer who underwent radical resection. A CEA-TD scoring system was developed and integrated with key clinicopathologic variables to construct a prognostic nomogram. Results: Both TD(+) and elevated CEA levels were independently associated with significantly worse overall survival (HR for TD = 1.985, CEA = 2.209; all P < 0.01). The CEA-TD score effectively stratified patients into four risk categories, each with distinct survival outcomes (P < 0.001). The final nomogram, incorporating CEA-TD score, T stage, N stage, grade, and tumor location, demonstrated high predictive performance, with AUCs of 0.796, 0.834, and 0.807 for 1-, 3-, and 5-year OS in the training cohort, and comparable values in internal and external validations. The C-index reached 0.800, outperforming traditional prognostic factors. Kaplan-Meier and risk curve analyses confirmed the model's discriminative capacity. Conclusions: The CEA-TD-based nomogram offers accurate, clinically applicable risk stratification for LOCC patients, supporting personalized
Keywords: Colon Cancer, Carcinoembryonic Antigen, tumor deposits, Prognostic model, nomogram
Received: 16 May 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Fan, Sun, Hu, Zhang, Dong, Liu, Zhang and Cai. 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: Ya'Nan Fan, fan_ya_nan123@163.com
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