Clinicopathological risk factors of Stage II colon cancer: results of a prospective study
Version of Record online: 27 MAR 2013
© 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland
Volume 15, Issue 4, pages 414–422, April 2013
How to Cite
Santos, C., López-Doriga, A., Navarro, M., Mateo, J., Biondo, S., Martínez Villacampa, M., Soler, G., Sanjuan, X., Paules, M. J., Laquente, B., Guinó, E., Kreisler, E., Frago, R., Germà, J. R., Moreno, V. and Salazar, R. (2013), Clinicopathological risk factors of Stage II colon cancer: results of a prospective study. Colorectal Disease, 15: 414–422. doi: 10.1111/codi.12028
- Issue online: 27 MAR 2013
- Version of Record online: 27 MAR 2013
- Accepted manuscript online: 13 SEP 2012 10:39AM EST
- Received 28 February 2012; accepted 30 July 2012; Accepted Article online 13 September 2012
- Colon cancer;
- adjuvant chemotherapy;
- colorectal surgery
Aim Adjuvant 5-fluorouracil based chemotherapy has demonstrated benefit in Stage III colon cancer but still remains controversial in Stage II. The aim of this study was to analyse the prognostic impact of clinicopathological factors that may help guide treatment decisions in Stage II colon cancer.
Method Between 1996 and 2006 data from patients diagnosed with colorectal cancer at Hospital Universitari Bellvitge and its referral comprehensive cancer centre Institut Català d′Oncologia/L’Hospitalet were prospectively included in a database. We identified 432 patients with Stage II colon cancer operated on at Hospital Universitari Bellvitge. The 5-year relapse-free survival (RFS) and colon-cancer-specific survival (CCSS) were determined.
Results The 5-year RFS and CCSS were 83% and 88%, respectively. Lymphovascular or perineural invasion was associated with RFS [hazard ratio (HR) 1.84; 95% CI 1.01–3.35]. Gender (women, HR 0.48; 95% CI 0.23–1) and lymphovascular or perineural invasion (HR 3.51; 95% CI 1.86–6.64) together with pT4 (HR 2.79; 95% CI 1.44–5.41) influenced CCSS. In multivariate analysis pT4 and lymphovascular or perineural invasion remained significantly associated with CCSS. We performed a risk index with these factors with prognostic impact. Patients with pT4 tumours and lymphovascular or perineural invasion had a 5-year CCSS of 61%vs the 93% (HR 5.87; 95 CI 2.46–13.97) of those without any of these factors.
Conclusion pT4 and lymphatic, venous or perineural invasion are confirmed as significant prognostic factors in Stage II colon cancer and should be taken into account in the clinical validation process of new molecular prognostic factors.