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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 9/2015

01-09-2015 | Original Article

A prognostic analysis of 895 cases of stage III colon cancer in different colon subsites

Authors: Yan Zhang, Junli Ma, Sai Zhang, Ganlu Deng, Xiaoling Wu, Jingxuan He, Haiping Pei, Hong Shen, Shan Zeng

Published in: International Journal of Colorectal Disease | Issue 9/2015

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Abstract

Purpose

Stage III colon cancer is currently treated as an entity with a unified therapeutic principle. The aim of the retrospective study is to explore the clinicopathological characteristics and outcomes of site-specific stage III colon cancers and the influences of tumor location on prognosis.

Methods

Eight hundred ninety-five patients with stage III colon cancer treated with radical operation and subsequent adjuvant chemotherapy (5-fluorouracil/oxaliplatin) were divided into seven groups according to colon segment (cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, and sigmoid colon). Expression of excision repair cross-complementing group 1 (ERCC1) and thymidylate synthase (TS) was examined by immunohistochemistry. We assessed if differences exist in patient characteristics and clinic outcomes between the seven groups.

Results

There were significant differences in tumor differentiation (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) stage (P < 0.001), metachronous liver metastasis (P < 0.001), metachronous lung metastasis (P < 0.001), and ERCCI expression (P < 0.001) between the seven groups. Both 5-year recurrence-free survival (RFS) and 5-year overall survival (OS) exhibited significant differences (both P < 0.001) with survival gradually decreasing from cecum to sigmoid colon. Cox regression analyses identified that tumor location was an independent prognostic factor for RFS and OS.

Conclusions

Stage III colon cancer located proximally carried a poorer survival than that located distally. Different efficacies of FOLFOX adjuvant chemotherapy may be an important factor affecting survival of site-specific stage III colon cancers.
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Metadata
Title
A prognostic analysis of 895 cases of stage III colon cancer in different colon subsites
Authors
Yan Zhang
Junli Ma
Sai Zhang
Ganlu Deng
Xiaoling Wu
Jingxuan He
Haiping Pei
Hong Shen
Shan Zeng
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 9/2015
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-015-2273-z

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