Kozak KR et al. - Rectal cancer patients experience widely varying survival rates based on extent of disease. A new risk classification system is proposed that provides better prognostic information than AJCC group staging, suggesting current rectal cancer staging systems may be improved with appropriate revisions. Methods
Study to examine the impact of T and N stages on long-term survival as well as the performance of associated risk classification systems
Pts who underwent surgery for rectal adenocarcinoma from 1988 to 2004
Kaplan-Meier survival analysis was performed for subgroups of pts defined by T and N stage
Results
For 30,826 pts, both T and N stage significantly impacted OS
N stage variably affected survival for subgroups of pts based on T stage, whereas T stage significantly affected survival regardless of N stage
A previously developed risk classification system that assigns 1/4 risk levels outperformed AJCC group staging in this cohort
Based on long-term outcomes, a modified risk classification system was constructed which was highly prognostic for long-term OS
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