Assessment of prognosis in patients with stage II colon cancer

Abstract

j coloproctol (rio j). 2 0 1 5;3 5(4):203-211 w w w . j c o l . o r g . b r Journal of Coloproctology Colon cancer High-and low-risk stage II Disease-free survival Disease-specific survival a b s t r a c t Pathologic staging is currently the most important prognostic factor in colon cancer, although individually this procedure does not provide a complete clinical outcome.This study aimed to determine the disease-specific survival of patients with colon cancer treated in the Braga Hospital from January 2005 to December 2013, according to the American Joint Committee on Cancer, 6th edition, and the disease-free survival and diseasespecific survival of high-and low-risk stage II patients, whether in use, or not, of adjuvant chemotherapy.We obtained a total sample of 578 patients, with 145 and 65 high-and low-risk stage II patients, respectively. We observed a 5-year disease-specific survival rate of 93%, 27.4% and 75% for stage IIA, IIB and IIIA patients, respectively, where IIIA and IIB present statistically significant differences (p = 0.001). In high-risk stage II patients, disease-free survival (p = 0.107) and disease-specific survival (p = 0.037) were higher in the group submitted to chemotherapy. In low-risk patients, disease-free survival was higher in the group submitted to chemotherapy (p = 0.494), while disease-specific survival was lower (p = 0.426).The differences observed between stage IIB and IIIA survival can be explained by the consensual use of adjuvant chemotherapy in stage IIIA, and by its controversial use in stage IIB. Adjuvant chemotherapy showed to be effective only in high-risk stage II patients in terms of disease-specific survival.In the future, other markers, namely molecular ones, may be used to stratify the risk of stage II patients and determine who will benefit from adjuvant chemotherapy. Avaliação o prognóstico de pacientes com cancer de colon no estadio IIPalavras-chave: Câncer de cólon Estadio II de alto risco e baixo risco Sobrevivência livre de doença r e s u m o O estadiamento patológico é, atualmente, o fator de prognóstico mais importante do câncer de cólon, embora individualmente não preveja totalmente o resultado clínico. Neste estudo, pretendeu-se determinar a sobrevivência para uma doença específica (SDE) dos pacientes com câncer de cólon tratados no Hospital de Braga entre janeiro de 2005 e 204 j coloproctol (rio j). 2 0 1 5;3 5(4):203-211 Sobrevivência para uma doença específica dezembro de 2013, de acordo com a 6 a edição da American Joint Committee on Cancer e a Sobrevivência Livre de Doença (SLD) e SDE dos doentes em estadio II, classificados em alto e baixo risco, de acordo com a realização ou não de quimioterapia adjuvante.Obtivemos uma amostra total de 578 pacientes, dos quais uma parcela pertencia ao estadio II de alto ou de baixo risco (145 e 65 pacientes, respetivamente). Observamos SDE a 5 anos de: 93%, 27,4% e 75% para os estadios IIA, IIB e IIIA, respetivamente; IIIA e IIB apresentaram diferenças significativas (p = 0,001). SLD (p = 0,107) e SDE (p = 0,037) pa...

Prognostic Factors for Left Colectomy for Colon Cancer: A Ten Years Experience of a Single University Institution

“…Radical surgery involves the removal of the intestinal segment involved by the tumor, which must include an adequate margin of resection and complete loco regional lymphadenectomy 23 . Complete removal of the tumor along with the major vascular pedicle and the lymphatic drainage, either by laparotomy or laparoscopy is the best curative option for patients with localized colonic cancer 8 , 14 , 15 . Left colectomy for the cancer localized at the descending and sigmoid colon is the procedure of choice for complete oncologic resection and favorable prognosis 3 .…”