Tumor size as a prognostic factor in patients with stage IIa colon cancer

Francesco Santullo; Alberto Biondi; Ferdinando C M Cananzi; Valeria Fico; Flavio Tirelli; Riccardo Ricci; Gianluca Rizzo; Claudio Coco; Claudio Mattana; Domenico D'Ugo; Roberto Persiani

doi:10.1016/j.amjsurg.2017.03.038

Tumor size as a prognostic factor in patients with stage IIa colon cancer

Am J Surg. 2018 Jan;215(1):71-77. doi: 10.1016/j.amjsurg.2017.03.038. Epub 2017 Apr 5.

Authors

Affiliations

¹ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: francescosantullo@gmail.com.
² General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: biondi.alberto@tiscali.it.
³ Surgical Oncology Unit - Humanitas Clinical and Research Center, Rozzano, Italy. Electronic address: ferdinando.cananzi@cancercenter.humanitas.it.
⁴ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: valeriafico@hotmail.it.
⁵ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: tirelliflavio@gmail.com.
⁶ Department of Pathology, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: riccardo.ricci@unicatt.it.
⁷ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: gianluca.rizzo1979@libero.it.
⁸ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: claudio.coco@unicatt.it.
⁹ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: claudio.mattana@unicatt.it.
¹⁰ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: domenico.dugo@unicatt.it.
¹¹ General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome, Italy. Electronic address: roberto.persiani@unicatt.it.

PMID: 28410630
DOI: 10.1016/j.amjsurg.2017.03.038

Abstract

Background: The aim of this study was to identify stage II colon cancer patients with a high risk of recurrence.

Methods: All patients who underwent surgery for stage II colon cancer (CC) were retrospectively enrolled and sub-grouped according to TNM staging (IIa-b-c) and stage IIa in high (IIaHR) and low risk (IIaLR) according to pathologic features. The primary outcomes measured were the 5-year overall survival (OS) and disease-free survival (DFS).

Results: A total of 214 patients were reviewed. Only a maximum tumor diameter<4 cm in the IIaLR group was associated with a higher recurrence rate than a large tumor size (5-year DFS 71.7%vs.87.6%, p = 0.028). The DFS in the large IIaLR CC group was better than that in the IIaHR and IIb-c groups (5-year DFS: 92.7%vs.79.3%, p = 0.023). In contrast, the recurrence rate in the small IIaLR CC group was similar to that in the IIaHR, IIb-c stage CC group.

Conclusions: In stage IIa CC evaluation of the tumor size as a prognostic factor may help identify patients who could benefit from additional postoperative therapy.

Keywords: Adiuvant treatment; Colorectal cancer; Prognosis; Stage II; Tumor size.

MeSH terms

Adenocarcinoma / diagnosis
Adenocarcinoma / mortality*
Adenocarcinoma / pathology*
Adenocarcinoma / surgery
Adult
Aged
Aged, 80 and over
Colectomy
Colonic Neoplasms / diagnosis
Colonic Neoplasms / mortality*
Colonic Neoplasms / pathology*
Colonic Neoplasms / surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / epidemiology
Neoplasm Recurrence, Local / pathology*
Neoplasm Staging
Prognosis
Retrospective Studies
Survival Analysis
Tumor Burden*