Analysis of stage and clinical/prognostic factors for colon and rectal cancer from SEER registries: AJCC and collaborative stage data collection system

Abstract

Background The Collaborative Stage (CS) Data Collection System enables multiple cancer registration programs to document anatomic and molecular pathology features that contribute to the Tumor (T), Node (N), Metastasis (M) (TNM) system of the American Joint Committee on Cancer (AJCC). This chapter highlights changes in CS for colon and rectal carcinomas as TNM moved from the AJCC 6th to the 7th edition. Methods Data from 18 Surveillance, Epidemiology, and End Results (SEER) population-based registries were analyzed for the years 2004-2010, which included 191 361colon and 73 341 rectal carcinomas. Results Overall, the incidence of colon and rectal cancer declined, with the greatest decrease in stage 0. The AJCC's 7th edition introduction of changes in the subcategorization of T4, N1, and N2 caused shifting within stage groups in 25 577 colon and 10 150 rectal cancers diagnosed in 2010. Several site-specific factors (SSFs) introduced in the 7th edition had interesting findings: 1) approximately 10% of colon and rectal cancers had tumor deposits - about 30-40% occurred without lymph node metastases which resulted in 2.5% of colon and 3.3% of rectal cases becoming N1c (stage III A/B) in AJCC 7th edition ; 2) 10% of colon and 12% of rectal cases had circumferential radial margins <1 mm; 3) about 46% of colorectal cases did not have a CEA testing or documented CEA information; and 4) about 10% of colorectal cases had perineural invasion. Conclusion Adoption of AJCC 7th edition by the SEER Program provides an assessment tool for staging and SSFs on clinical outcomes. This evidence can be used for education and improved treatment for colorectal carcinomas.

Prognostic value of tumour deposit and perineural invasion status in colorectal cancer patients: a SEER‐based population study

“…also examined the impact of PNI‐positive status on disease‐free and CSS of 381 patients, examining colon and rectal cancers separately . In contrast, the present study included a much larger number of patients (41 323 patients with known TD status and 41 215 with known PNI status) than recent studies on TD (17 614 patients with known TD status, but no survival analysis) and PNI (only 249 patients). Additionally, our multivariable models confirmed the independent prognostic values of some known prognostic factors including age, tumour grade, T category, N category and tumour location.…”

Overexpression of mRNA‑decapping enzyme 1a affects survival rate in colorectal carcinoma

“…The classification of the 118 cases was performed according to the American Joint Committee on Cancer 2010 classification system (15)(16)(17). The enrolled patients had not received any previous form of preoperative therapy.…”

Multidisciplinary management of stage IV colon cancer

“…These patients face an overall survival (OS) of 13% as reported from the Surveillance Epidemiology and End Result (SEER) Program. 2 However, it is clear that this patient population is highly heterogeneous in their disease burden and tumor biology. Tremendous progress has been made in systemic chemotherapy for metastatic CRC, and the median survival times in recent clinical trials have reached 24 to 30 months.…”