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Defining a high-risk subgroup with colon cancer stages I and II for possible adjuvant therapy
European Journal of Cancer, 08/21/09

Gertler R et al. - In a study to identify clinicopathologic characteristics in colon cancer stages I and II that are associated with increased risk of tumour recurrence and tumour-related death, it was shown that pts with stage I or II colon cancer have a favourable prognosis after radical resection. Presence of 2 or 3 poor prognostic tumour characteristics identifies a small pt subgroup (12%) with increased risk of tumour-related death that may be considered for adjuvant chemotherapy.

Methods

A documented clinical database of 775 pts with colon cancer stages I and II was analyzed, which underwent curative resection between 1982 and 2006.
No adjuvant chemotherapy was applied.
Median follow-up time was 80 mos.

Results

5- and 10-yr tumour-specific survival probabilities were 94.8±0.9% and 91.0±1.4%, respectively.
Multivariate analysis identified 3 tumour characteristics as independent prognostic factors: lymphatic vessel invasion, poor tumour grading (G3/G4), and extended tumour length (6 cm).
5-yr (10-yr) tumour-specific survival for pts without any of the poor prognostic tumour characteristics (ppTCs) was 96.0% (94.7%).
There was a significantly increased risk for tumour-related death with increasing numbers of ppTCs.
While pts with only 1 ppTC had a 5-yr (10-yr) tumour-specific survival of 94.8% (88.9%), it decreased to 88.9% (78.4%) for pts with 2 ppTCs and to 87.5% (72.9%) for pts with all 3 ppTCs.

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