Factors predicting worse prognosis in patients affected by pT3 N0 colon cancer: long-term results of a monocentric series of 137 radically resected patients in a 5-year period

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• 作者：Roberto Biffi (1)
  Edoardo Botteri (2) (3)
  Emilio Bertani (4)
  Maria Giulia Zampino (5)
  Sabina Cenciarelli (1)
  Fabrizio Luca (1)
  Simonetta Pozzi (1)
  Maria Laura Cossu (1)
  Antonio Chiappa (4)
  Nicole Rotmensz (2)
  Barbara Bazolli (2)
  Elena Magni (5)
  Angelica Sonzogni (6)
  Bruno Andreoni (4)
  
• 关键词：Colon cancer ; TNM stage ; Lymphadenectomy ; Radical colectomy
• 刊名：International Journal of Colorectal Disease
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：28
• 期：2
• 页码：207-215
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• 作者单位：Roberto Biffi (1)
  Edoardo Botteri (2) (3)
  Emilio Bertani (4)
  Maria Giulia Zampino (5)
  Sabina Cenciarelli (1)
  Fabrizio Luca (1)
  Simonetta Pozzi (1)
  Maria Laura Cossu (1)
  Antonio Chiappa (4)
  Nicole Rotmensz (2)
  Barbara Bazolli (2)
  Elena Magni (5)
  Angelica Sonzogni (6)
  Bruno Andreoni (4)
  
  1. Division of Abdomino-Pelvic and Minimally Invasive Surgery, European Institute of Oncology, Via G. Ripamonti, 435, 20141, Milan, Italy
  2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
  3. Department of Occupational Health, University of Milan, Milan, Italy
  4. Division of General and Laparoscopic Surgery, European Institute of Oncology, Milan, Italy
  5. Division of Medical Oncology, European Institute of Oncology, Milan, Italy
  6. Division of Pathology, European Institute of Oncology, Milan, Italy
  
• ISSN：1432-1262

文摘

Background and purpose For patients with Stage II colon cancer, the use of adjuvant chemotherapy remains controversial. The purpose of this study was to identify clinical and/or pathological findings related to a worse prognosis in this category of patients. Patients and methods We retrospectively analyzed the data of consecutive patients, extracted by an institutional Tumour Registry, admitted to an affiliated University Hospital in Milan (European Institute of Oncology) for adenocarcinoma of the colon (all sites), between 2000 and 2005, and having a final pT3 N0 pathology staging after curative surgery. Adjuvant chemotherapy was decided as a result of a medical decision within a multidisciplinary Tumor Board. Results Data of 137 patients were obtained, with a median follow-up of 77?months (range 6-31). Patients who received chemotherapy were younger than patients who did not. Nine patients out of 137 (6.5?%) died as a consequence of colon cancer recurrence; four of them had received adjuvant chemotherapy. Only histological grade III and mucinous histotype were found to impact on cumulative incidence of colon-related events (p 0.03 and 0.02, respectively); no impact was found on cumulative incidence of colonic neoplasm recurrence-related deaths (p 0.74 and 0.74, respectively). Number of analyzed LNs (lymph nodes) emerged as a factor possibly affecting the cumulative incidence of colon-related events (p 0.09) as well as the cumulative incidence of colonic neoplasm recurrence-related deaths (p 0.10). The risk of events was inversely proportional to the number of dissected LNs, even over 20 up to about 25 LNs. Never-smokers exhibited a lower incidence of colon-related events, although the difference was not statistically significant (p 0.09). All other analyzed variables did not show any impact on survival rate, including age, gender, ASA score, BMI, site of colonic neoplasm, multifocality, perivascular invasion, and use of adjuvant chemotherapy. Conclusions Histology grading G3 and mucinous histotype were predictors of worse outcome. Efforts to improve LN evaluation should result in clinically significant improvements in outcome, and also the quality of care for patients with radically resected stage II colon cancer.