Prognostic Factors Assessed for 15,096 Patients with Colon Cancer in Stages I and II

Mroczkowski, Pawel; Schmidt, Uwe; Sahm, Maik; Gastinger, Ingo; Lippert, Hans; Kube, Rainer
July 2012
World Journal of Surgery;Jul2012, Vol. 36 Issue 7, p1693
Academic Journal
Background: We focused on the risk factors for poor outcome after curative resection of a colon cancer in UICC stages I and II based on the data of the Germany-wide quality assurance study 'colon/rectum cancer (primary tumor).' In some countries, all stage II colon cancer patients are encouraged to participate in a clinical trial. We feel that this approach is too broad. Methods: Using the data of 15,096 patients operated on from January 1, 2000 to December 31, 2004, the following factors were analyzed with the Cox regression model: age, comorbidities, ASA score, gender, localization of the tumor (left colon vs. right colon), perioperative complications (yes/no), pT stage, grading (G1/G2 vs. G3/G4), L-status (lymph vessels invasion yes/no), and V-status (venous invasion yes/no). Results: The probability of a local relapse in stages I and II was 1.5 and 4.6%, respectively, or distant metastases 4.7 and 10.2%, respectively. Only pT stage [hazard ratio (HR) for pT1 = 1, pT2 = 1.821, pT3 = 2.735, and pT4 = 5.881], L-status (HR for L1 = 1.393), age (HR per year = 1.021), as well as ASA score IV (HR = 4.536) had significant influence on tumor-free survival. Conclusions: Despite favorable prognosis and R0 resection, a small percentage of patients will still relapse. The most important risk factor comprising the tumor-free survival is the pT stage followed by L-status and age. These results should be taken into consideration when determining the course for adjuvant chemotherapy, especially if the course includes the recommendation of clinical trial participation for stage II colon cancer patients after an R0 resection.


Related Articles

  • Improved Lymph Node Harvest from Resected Colon Cancer Specimens Did Not Cause Upstaging from TNM Stage II to III. Storli, Kristian; Søndenaa, Karl; Furnes, Bjørg; Leh, Sabine; Nesvik, Idunn; Bru, Tore; Gudlaugsson, Einar; Bukholm, Ida; Norheim-Andersen, Solveig; Eide, Geir // World Journal of Surgery;Dec2011, Vol. 35 Issue 12, p2796 

    Background: The number of lymph nodes retrieved and examined from a resected colon cancer specimen may be crucial for correct staging. We examined if efforts to increase the lymph node harvest to more than 12 lymph nodes per specimen would upstage some patients from TNM stage II to III. Methods:...

  • Should adjuvant chemotherapy be withheld from any patient with operable breast cancer? Langlands, Allan O.; Gore, Sheila M.; Kerr, Gillian M. // British Medical Journal (Clinical Research Edition);9/11/1982, Vol. 285 Issue 6343, p680 

    Focuses on the use of adjuvant chemotherapy in the management of breast cancer. Evaluation on the effects of combined adjuvant drugs; Consideration on the histological staging of axillary nodes; Assessment on the benefits of the therapy from the clinical trials.

  • Comparison of survival of patients receiving laparoscopic and open radical resection for stage II colon cancer. Cui-Zhen Fan; Yu-Ping Chu; Ping Wei; Hong Dai; Wenming Chen // Radiology & Oncology;2011, Vol. 45 Issue 4, p273 

    Background. The aim of the study was to compare the survival of patients receiving laparoscopic vs. open radical resection for stage II colon cancer. Patients and methods. Two hundred and twenty patients with stage II colon cancer were enrolled from Beijing Chaoyang Hospital of Capital Medical...

  • The prognostic significance of the postoperative prognostic nutritional index in patients with colorectal cancer. Masatsune Shibutani; Kiyoshi Maeda; Hisashi Nagahara; Hiroshi Ohtani; Yasuhito Iseki; Tetsuro Ikeya; Kenji Sugano; Kosei Hirakawa // BMC Cancer;Jul2015, Vol. 15 Issue 1, p1 

    Background: The preoperative prognostic nutritional index (PNI) has been reported to correlate with the prognosis in patents with various carcinomas. However, the prognostic significance of the postoperative PNI is unknown. The aim of this study was to evaluate the prognostic significance of the...

  • Colorectal squamous cell carcinoma: a rare tumor with poor prognosis. Ozuner, Gokhan; Aytac, Erman; Gorgun, Emre; Bennett, Ana // International Journal of Colorectal Disease;Jan2015, Vol. 30 Issue 1, p127 

    Purpose: Primary squamous cell carcinomas of the colon and rectum are extremely rare, with an incidence of less than 1 % of colorectal malignancies. Our aim in this study was to evaluate patient characteristics, treatment strategy, and postoperative follow-up of patients with colorectal squamous...

  • Post-Operative Plasma Osteopontin Predicts Distant Metastasis in Human Colorectal Cancer. Ng, Lui; Wan, Timothy Ming-Hun; Lam, Colin Siu-Chi; Chow, Ariel Ka-Man; Wong, Sunny Kit-Man; Man, Johnny Hon-Wai; Li, Hung-Sing; Cheng, Nathan Shiu-Man; Pak, Ryan Chung-Hei; Cheung, Alvin Ho-Kwan; Yau, Thomas Chung-Cheung; Lo, Oswens Siu-Hung; Foo, Dominic Chi-Chung; Poon, Jensen Tung-Chung; Poon, Ronnie Tung-Ping; Pang, Roberta Wen-Chi; Law, Wai-Lun // PLoS ONE;May2015, Vol. 10 Issue 5, p1 

    Background: The overall prognosis of colorectal cancer (CRC) patients is unsatisfactory due to cancer metastasis after operation. This study aims to investigate the clinical significance of plasma osteopontin (OPN) levels as minimally invasive, predictive, and surrogate biomarkers for prognosis...

  • Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial. Giessen, C; Fischer von Weikersthal, L; Laubender, R P; Stintzing, S; Modest, D P; Schalhorn, A; Schulz, C; Heinemann, V // British Journal of Cancer;9/17/2013, Vol. 109 Issue 6, p1428 

    Background:Liver-limited disease (LLD) denotes a specific subgroup of metastatic colorectal cancer (mCRC) patients.Patients and Methods:A total of 479 patients with unresectable mCRC from an irinotecan-based randomised phase III trial were evaluated. Patients with LLD and non-LLD and hepatic...

  • Distal and proximal colon cancers differ in terms of molecular, pathological, and clinical features. Missiaglia, E.; Jacobs, B.; D'Ario, G.; Di Narzo, A. F.; Soneson, C.; Budinska, E.; Popovici, V.; Vecchione, L.; Gerster, S.; Yan, P.; Roth, A. D.; Klingbiel, D.; Bosman, F. T.; Delorenzi, M.; Tejpar, S. // Annals of Oncology;Oct2014, Vol. 25 Issue 10, p1995 

    Our study supports the notion that tumors arising in the distal or proximal colon develop along different tumorigenic pathways, leading to carcinomas with unique characteristics, showing differences in prognosis and response to targeted therapy.Background Differences exist between the proximal...

  • Prognostic value of KRAS mutations in stage III colon cancer: post hoc analysis of the PETACC8 phase III trial dataset. Blons, H.; Emile, J. F.; Le Malicot, K.; Julié, C.; Zaanan, A.; Tabernero, J.; Mini, E.; Folprecht, G.; Van Laethem, J. L.; Thaler, J.; Bridgewater, J.; Nørgård-Petersen, L.; Van Cutsem, E.; Lepage, C.; Zawadi, M. A.; Salazar, R.; Laurent-Puig, P.; Taieb, J. // Annals of Oncology;Dec2014, Vol. 25 Issue 12, p2378 

    On this prospective randomized trial dataset a shorter time to recurrence is associated with KRAS codon 12 mutations in patients with BRAF wild-type stage III distal colon cancer. A clear trend was also noted for the p.G13D mutation suggesting that KRAS exon 2 mutations are related to a worse...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics