Prognostic Factors after Potentially Curative Resection in Stage II or III Colon Cancer

Abstract

It is important to identify factors that are predictive of outcome after a curative resection in colon cancer in order to optimize adjuvant therapy. To investigate these prognostic factors we conducted a retrospective analysis of our clinicopathological data. A total of 190 patients with a pathological stage II or III colon cancer underwent potentially curative resection with lymphadenectomy at our hospital between 1990 and 1998. These patients received no preoperative chemotherapy, immunotherapy or radiotherapy. Postoperative adjuvant chemotherapy using oral fluoropyrimidines was performed in 127 patients, and the other 63 patients underwent surgery alone. Univariate and multivariate analyses for prognostic factors were carried out. The univariate analysis revealed that invasion to adjacent organs, N1-2, positive mesenteric lymph node metastasis (MLN+), lymphatic permeation (ly)1-3, venous invasion (v)1-3, and v2-3 were each significant factors indicating worse disease-free survival, and that N1-2, MLN+, ly1-3, v1-3 and v2-3 were each significant factors for worse overall survival. In the multivariate analysis, MLN+ and vl-3 were significant factors for worse disease-free survival, and for worse overall survival. In conclusion, stage II or III colon cancer patients positive for mesenteric lymph node metastasis or for venous invasion have a greater risk of recurrence and death after potentially curative resection. Postoperative adjuvant chemotherapy using oral fluoropyrimidines did not significantly reduce the risk of recurrence and death in these patients. More effective adjuvant chemotherapy than oral fluoropyrimidine should be considered, especially in such high-risk patients.

A Comparative Study of Cox Regression vs. Log-Logistic Regression (with and without its frailty) in Estimating Survival Time of Patients with Colorectal Cancer

“…In many studies, metastasis to nearby lymph nodes is introduced as an independent variable associated with survival of patients (Berti et al, 1983;Park et al, 1999;OGATA et al, 2005). Also, in the current study, the variable relationship with survival time was significant in both univariate and multivariate analysis.…”

Clinical compliance with an oral uracil/tegafur (UFT) plus leucovorin (LV) regimen as adjuvant chemotherapy in Japanese colorectal cancer patients

“…The postoperative pathological fi ndings in the eight stage II patients in our study showed positivity for moderate microscopic venous invasion, and microscopic venous invasion has been reported to be a highrisk factor in stage II patients. 11 No age limit was placed on those receiving the oral UFT plus LV regimen in the present study, but we chose not to administer oral UFT plus LV to patients with performance status 2 or more. Five elderly patients (75 years of age or older) were treated with oral UFT plus LV.…”

Evaluation of clinical, laboratory and morphologic prognostic factors in colon cancer

“…Although surgical therapy is the basis of treatment for patients with colon cancer, multimodal therapeutical concepts are currently applied not only in metastatic disease and Dukes C patients but also in Dukes B [ 18 - 20 ]. Further, the introduction of new drugs has extended the therapeutic options [ 21 , 22 ] and ongoing studies with novel targeted therapies will show their results in the next years.…”