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Objective <p>To investigate the prognostic value of lymphovascular invasion (LVI) and preoperative carcinoembryonic antigen (CEA) level for cancer-specific survival (CSS) in octogenarian (≥ 80 years) colorectal cancer (CRC) patients, and to explore the modifying effects of tumor laterality and histological subtype on this prognostic value.</p> Methods <p>This retrospective cohort study enrolled 214 octogenarian CRC patients and 214 age-matched younger patients (50–79 years) as controls. The associations between LVI/CEA status and clinicopathological characteristics were analyzed. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate prognostic impacts, with subgroup analyses by tumor laterality and histological subtype.</p> Results <p>Octogenarian patients had higher rates of LVI positivity (38.3% vs. 29.9%, <i>P</i> = 0.042) and elevated CEA (41.1% vs. 32.7%, <i>P</i> = 0.038) than younger patients, with a lower 5-year CSS rate (52.3% vs. 68.7%, <i>P</i> &lt; 0.001). LVI positivity (HR = 2.14, 95% CI = 1.57–2.91, <i>P</i> &lt; 0.001) and elevated CEA (HR = 1.87, 95% CI = 1.35–2.59, <i>P</i> &lt; 0.001) were independent prognostic factors for worse CSS in octogenarians, with more pronounced adverse effects in right-sided colon cancer and adenocarcinoma subtypes.</p> Conclusion <p>LVI positivity and elevated preoperative CEA levels are independent prognostic factors for poor CSS in octogenarian CRC patients. Their prognostic impact varies by tumor laterality and histological subtype, highlighting the need for personalized risk stratification in this population.</p>

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Prognostic value of lymphovascular invasion and CEA for cancer-specific survival in octogenarian colorectal cancer patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月22日

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  • Xiuping Weng,
  • Yangyang Zhou,
  • Yunzhu Zhang,
  • Xiexi Fang,
  • Rongbin Xu,
  • Yiqiang Wang,
  • Qi Qiu,
  • Xiaoyuan Chen

摘要

Objective

To investigate the prognostic value of lymphovascular invasion (LVI) and preoperative carcinoembryonic antigen (CEA) level for cancer-specific survival (CSS) in octogenarian (≥ 80 years) colorectal cancer (CRC) patients, and to explore the modifying effects of tumor laterality and histological subtype on this prognostic value.

Methods

This retrospective cohort study enrolled 214 octogenarian CRC patients and 214 age-matched younger patients (50–79 years) as controls. The associations between LVI/CEA status and clinicopathological characteristics were analyzed. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate prognostic impacts, with subgroup analyses by tumor laterality and histological subtype.

Results

Octogenarian patients had higher rates of LVI positivity (38.3% vs. 29.9%, P = 0.042) and elevated CEA (41.1% vs. 32.7%, P = 0.038) than younger patients, with a lower 5-year CSS rate (52.3% vs. 68.7%, P < 0.001). LVI positivity (HR = 2.14, 95% CI = 1.57–2.91, P < 0.001) and elevated CEA (HR = 1.87, 95% CI = 1.35–2.59, P < 0.001) were independent prognostic factors for worse CSS in octogenarians, with more pronounced adverse effects in right-sided colon cancer and adenocarcinoma subtypes.

Conclusion

LVI positivity and elevated preoperative CEA levels are independent prognostic factors for poor CSS in octogenarian CRC patients. Their prognostic impact varies by tumor laterality and histological subtype, highlighting the need for personalized risk stratification in this population.