A Survival Regression Analysis of Prognostic Factors in Colorectal Cancer

Abstract

Background: Many prognostic factors of colorectal cancer are known but their actual clinical validity is still uncertain. The aim of the present study was to verify, on the basis of our experience, the prognostic validy of variables for survival by using survival regression analysis. Methods: From January 1978 to December 1986 the prognostic factors for 192 patients were analysed. These patients had undergone surgical resection for colorectal cancer. The follow up was completed in every patient by the end of December 1992. with a median follow up of 10 years (range 6-14 years). The prognostic factors considered in the statistical analysis were age. sex, size of tumour, site, grade, direct spread, node involvement and stage (according to Astler-Coller and pTNM). Results: Of the prognostic factors, sex was the only one not to show any prognostic significance. In the survival regression analysis we have used an accelerated failure time model (equivalent to the Cox proportional hazard model); age. grade and stage were significant covariables. Conclusions: Although clinical pathological staging (pTNM) appears as a pre-eminent prognostic factor, and as our analysis shows. it needs a further variable (grading), which has been shown to affect the prognosis in a significant way.

New insights into the role of age and carcinoembryonic antigen in the prognosis of colorectal cancer

“…Thus, different age ranges of the populations studied, or different age groups chosen for the analyses, together with a variable prevalence of nonneoplastic diseases in the evaluated series, can explain the discordant results in the scientific literature regarding age and colorectal cancer. Indeed, different authors have found an independent unfavourable effect of increasing age (Korenaga et al, 1991;Gasser et al, 1992;Crocetti et al, 1996;D'Eredita et al, 1996;Wolters et al, 1996;Payne and Meyer, 1997;Tominaga et al, 1997;Heys et al, 1998;Lagautriere et al, 1998;Fietkau et al, 2004;Munemoto et al, 2004), of the youngest and oldest age ranges, indifferently (Chung et al, 1998;Cerottini et al, 1999;Massacesi et al, 2002) or even of young age (Cai et al, 2005), while other investigators were not able to demonstrate any prognostic effect at all (Ponz de Leon et al, 1992;Wang et al, 2000;Mitry et al, 2004;Latkauskas et al, 2005). Only JanssenHeijnen et al (2005) evaluated relative survival of patients with several cancers, utilising data from the Southern Netherlands Cancer Registry.…”

Can patient satisfaction with quality of life predict survival in advanced colorectal cancer?

“…Despite significant advances in early diagnosis and treatment, 5-year survival rates for stages III and IV colorectal cancer remain poor. Various clinical, biochemical, and histological prognostic factors for advanced colorectal cancer were identified, and tumor stage is the most decisive prognostic factor in both univariate and multivariate analyses [2][3][4]. Other prognostic factors for colorectal cancer include age, tumor grade, tumor size and location, symptom duration, vascular and neural invasion, and nutritional status [5,6].…”

Pathology Report in Colon Cancer: What Is Prognostically Important?

“…It distortion of the anatomy by tumor and/or lack of anatomic landmarks that make it possible to differentiate the is recorded as an element of tumor documentation, but tumor size is not related to outcome. Eight separate studproximal from the distal end of the resected segment, orientation of the specimen may be difficult in some cases, ies have shown tumor size to be of no prognostic significance in colorectal cancer [26][27][28][29][30][31][32][33]. and assistance from the surgeon may be required.…”