Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2008

Open Access 01-12-2008 | Research

Evaluation of clinical, laboratory and morphologic prognostic factors in colon cancer

Authors: Michele Grande, Giovanni Milito, Grazia Maria Attinà, Federica Cadeddu, Marco Gallinella Muzi, Casimiro Nigro, Francesco Rulli, Attilio Maria Farinon

Published in: World Journal of Surgical Oncology | Issue 1/2008

Login to get access

Abstract

Background

The long-term prognosis of patients with colon cancer is dependent on many factors. To investigate the influence of a series of clinical, laboratory and morphological variables on prognosis of colon carcinoma we conducted a retrospective analysis of our data.

Methods

Ninety-two patients with colon cancer, who underwent surgical resection between January 1999 and December 2001, were analyzed. On survival analysis, demographics, clinical, laboratory and pathomorphological parameters were tested for their potential prognostic value. Furthermore, univariate and multivariate analysis of the above mentioned data were performed considering the depth of tumour invasion into the bowel wall as independent variable.

Results

On survival analysis we found that depth of tumour invasion (P < 0.001; F-ratio 2.11), type of operation (P < 0.001; F-ratio 3.51) and CT scanning (P < 0.001; F-ratio 5.21) were predictors of survival. Considering the degree of mural invasion as independent variable, on univariate analysis, we observed that mucorrhea, anismus, hematocrit, WBC count, fibrinogen value and CT scanning were significantly related to the degree of mural invasion of the cancer. On the multivariate analysis, fibrinogen value was the most statistically significant variable (P < 0.001) with the highest F-ratio (F-ratio 5.86). Finally, in the present study, the tumour site was significantly related neither to the survival nor to the mural invasion of the tumour.

Conclusion

The various clinical, laboratory and patho-morphological parameters showed different prognostic value for colon carcinoma. In the future, preoperative prognostic markers will probably gain relevance in order to make a proper choice between surgery, chemotherapy and radiotherapy. Nevertheless, current data do not provide sufficient evidence for preoperative stratification of high and low risk patients. Further assessments in prospective large studies are warranted.
Literature
1.
go back to reference Liang H, Wang XN, Wang BJ, Pan Y, Liu N, Wang DC, Hao XS: Prognostic factors of young patients with colon cancer after surgery. World J Gastroenterol. 2006, 12 (9): 1458-1462.PubMedCentralPubMed Liang H, Wang XN, Wang BJ, Pan Y, Liu N, Wang DC, Hao XS: Prognostic factors of young patients with colon cancer after surgery. World J Gastroenterol. 2006, 12 (9): 1458-1462.PubMedCentralPubMed
2.
go back to reference Bosman FT: Prognostic value of pathological characteristics of colorectal cancer. Eur J Cancer. 1995, 31A (7/8): 1216-1221. 10.1016/0959-8049(95)00153-A.CrossRefPubMed Bosman FT: Prognostic value of pathological characteristics of colorectal cancer. Eur J Cancer. 1995, 31A (7/8): 1216-1221. 10.1016/0959-8049(95)00153-A.CrossRefPubMed
3.
go back to reference Kuzu MA, Koksoy C, Kale T, Demirpence E, Renda N: Experimental study of the effect of preoperative 5-fluorouracil on the integrity of colonic anastomoses. Br J Surg. 1998, 85 (2): 236-9. 10.1046/j.1365-2168.1998.02876.x.CrossRefPubMed Kuzu MA, Koksoy C, Kale T, Demirpence E, Renda N: Experimental study of the effect of preoperative 5-fluorouracil on the integrity of colonic anastomoses. Br J Surg. 1998, 85 (2): 236-9. 10.1046/j.1365-2168.1998.02876.x.CrossRefPubMed
4.
go back to reference Ponz de Leon M, Sant M, Micheli A, Sacchetti C, Di Gregorio C, Fante R, Zanghieri G, Melotti G, Gatta G: Clinical and pathologic prognostic indicators in colorectal cancer. Cancer. 1992, 69: 626-635. 10.1002/1097-0142(19920201)69:3<626::AID-CNCR2820690305>3.0.CO;2-#.CrossRefPubMed Ponz de Leon M, Sant M, Micheli A, Sacchetti C, Di Gregorio C, Fante R, Zanghieri G, Melotti G, Gatta G: Clinical and pathologic prognostic indicators in colorectal cancer. Cancer. 1992, 69: 626-635. 10.1002/1097-0142(19920201)69:3<626::AID-CNCR2820690305>3.0.CO;2-#.CrossRefPubMed
5.
go back to reference Wiggers T, Arends JW, Volovics A: Regression analisys of prognostic factors in colorectal cancer after curative resections. Dis Colon Rectum. 1988, 31: 33-41. 10.1007/BF02552567.CrossRefPubMed Wiggers T, Arends JW, Volovics A: Regression analisys of prognostic factors in colorectal cancer after curative resections. Dis Colon Rectum. 1988, 31: 33-41. 10.1007/BF02552567.CrossRefPubMed
6.
go back to reference Gervaz P, Bouzourene H, Cerottini J-P, Chaubert P, Benhattar J, Secic M, Wexner S, Givel J-C: Dukes B colorectal cancer: distinct genetic categories and clinical outcome based on proximal or distal tumor location. Dis Colon Rectum. 2001, 44: 364-373. 10.1007/BF02234734.CrossRefPubMed Gervaz P, Bouzourene H, Cerottini J-P, Chaubert P, Benhattar J, Secic M, Wexner S, Givel J-C: Dukes B colorectal cancer: distinct genetic categories and clinical outcome based on proximal or distal tumor location. Dis Colon Rectum. 2001, 44: 364-373. 10.1007/BF02234734.CrossRefPubMed
7.
go back to reference Gonzalez EC, Roetzheim RG, Ferrante JM, Campbell R: Predictors of proximal vs. distal colorectal cancers. Dis Colon Rectum. 2001, 44: 251-258. 10.1007/BF02234301.CrossRefPubMed Gonzalez EC, Roetzheim RG, Ferrante JM, Campbell R: Predictors of proximal vs. distal colorectal cancers. Dis Colon Rectum. 2001, 44: 251-258. 10.1007/BF02234301.CrossRefPubMed
8.
go back to reference Tominaga T, Sakabe T, Koyama Y, Hamano K, Yasutomi M, Takahashi T, Kodaira S, Kato T, Ogawa N: Prognostic factors for patients with colon or rectal carcinoma treated with resection only. Cancer. 1996, 78: 403-8. 10.1002/(SICI)1097-0142(19960801)78:3<403::AID-CNCR4>3.0.CO;2-K.CrossRefPubMed Tominaga T, Sakabe T, Koyama Y, Hamano K, Yasutomi M, Takahashi T, Kodaira S, Kato T, Ogawa N: Prognostic factors for patients with colon or rectal carcinoma treated with resection only. Cancer. 1996, 78: 403-8. 10.1002/(SICI)1097-0142(19960801)78:3<403::AID-CNCR4>3.0.CO;2-K.CrossRefPubMed
9.
go back to reference National Cooperative Group on Pathology and Prognosis of colorectal cancer: Pathology and prognosis of colorectal cancer in Chinese young patients-an analysis of 319 cases. Zhonghua Zhong Liu Za Zhi. 1986, 8: 146-148. National Cooperative Group on Pathology and Prognosis of colorectal cancer: Pathology and prognosis of colorectal cancer in Chinese young patients-an analysis of 319 cases. Zhonghua Zhong Liu Za Zhi. 1986, 8: 146-148.
10.
go back to reference Alici S, Aykan NF, Sakar B, Bulutlar G, Kaytan E, Topuz E: Colorectal cancer in young patients: characteristics and outcome. Tohoku J Exp Med. 2003, 199: 85-93. 10.1620/tjem.199.85.CrossRefPubMed Alici S, Aykan NF, Sakar B, Bulutlar G, Kaytan E, Topuz E: Colorectal cancer in young patients: characteristics and outcome. Tohoku J Exp Med. 2003, 199: 85-93. 10.1620/tjem.199.85.CrossRefPubMed
11.
go back to reference O'connell JB, Maggard MA, Sack J, Ko CY: A 10-Year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum. Dis Colon Rectum. 2005, 48: 1161-1168. 10.1007/s10350-004-0932-1.CrossRefPubMed O'connell JB, Maggard MA, Sack J, Ko CY: A 10-Year outcomes evaluation of mucinous and signet-ring cell carcinoma of the colon and rectum. Dis Colon Rectum. 2005, 48: 1161-1168. 10.1007/s10350-004-0932-1.CrossRefPubMed
12.
go back to reference Morris M, Platell C, de Boer B, McCaul K, Iacopetta B: Population-based study of prognostic factors in stage II colonic cancer. British Journal of Surgery. 2006, 93: 866-871. 10.1002/bjs.5345.CrossRefPubMed Morris M, Platell C, de Boer B, McCaul K, Iacopetta B: Population-based study of prognostic factors in stage II colonic cancer. British Journal of Surgery. 2006, 93: 866-871. 10.1002/bjs.5345.CrossRefPubMed
13.
go back to reference Petersen VC, Baxter KJ, Love SB, Shepherd NA: Identification of objective pathological prognostic determinants and models of prognosis in Duke's B colon cancer. Gut. 2002, 51: 65-69. 10.1136/gut.51.1.65.PubMedCentralCrossRefPubMed Petersen VC, Baxter KJ, Love SB, Shepherd NA: Identification of objective pathological prognostic determinants and models of prognosis in Duke's B colon cancer. Gut. 2002, 51: 65-69. 10.1136/gut.51.1.65.PubMedCentralCrossRefPubMed
14.
go back to reference Burdy G, Panis Y, Alves A, Nemeth J, Lavergne-Slove A, Valleur P: Identifying patients with T3–T4 node-negative colon cancer at high risk of recurrence. Dis Colon Rectum. 2001, 44: 1682-1688. 10.1007/BF02234390.CrossRefPubMed Burdy G, Panis Y, Alves A, Nemeth J, Lavergne-Slove A, Valleur P: Identifying patients with T3–T4 node-negative colon cancer at high risk of recurrence. Dis Colon Rectum. 2001, 44: 1682-1688. 10.1007/BF02234390.CrossRefPubMed
15.
go back to reference Mulcahy HE, Toner M, Patchett SE, Daly L, O'Donoghue DP: Identifying stage B colorectal cancer patients at high risk of tumor recurrence and death. Dis Colon Rectum. 1997, 40: 326-331. 10.1007/BF02050424.CrossRefPubMed Mulcahy HE, Toner M, Patchett SE, Daly L, O'Donoghue DP: Identifying stage B colorectal cancer patients at high risk of tumor recurrence and death. Dis Colon Rectum. 1997, 40: 326-331. 10.1007/BF02050424.CrossRefPubMed
16.
go back to reference Diculescu M, Iacob R, Iacob S, Croitoru A, Becheanu G, Popeneciu V: The importance of Histopathological and clinical variables in predicting the evolution of colon cancer. Rom J Gastroenterol. 2002, 11 (3): 183-9.PubMed Diculescu M, Iacob R, Iacob S, Croitoru A, Becheanu G, Popeneciu V: The importance of Histopathological and clinical variables in predicting the evolution of colon cancer. Rom J Gastroenterol. 2002, 11 (3): 183-9.PubMed
17.
go back to reference Kubota K, Akasu T, Fujita S, Sugihara K, Moriya Y, Yamamoto S: Clinical and pathological prognostic indicators with colorectal mucinous carcinomas. Hepatogastroenterology. 2004, 51 (55): 142-6.PubMed Kubota K, Akasu T, Fujita S, Sugihara K, Moriya Y, Yamamoto S: Clinical and pathological prognostic indicators with colorectal mucinous carcinomas. Hepatogastroenterology. 2004, 51 (55): 142-6.PubMed
18.
go back to reference Mamounas E, Wieand S, Wolmark N, Bear HD, Atkins JN, Song K, Jones J, Rockette H: Comparative efficacy of adjuvant chemotherapy in patients with Dukes' B versus Dukes' C colon cancer: results from four National Surgical Adjuvant Breast and Bowel Project adjuvant studies (C-01, C-02, C-03, and C-04). J Clin Oncol. 1999, 17 (5): 1349-55.PubMed Mamounas E, Wieand S, Wolmark N, Bear HD, Atkins JN, Song K, Jones J, Rockette H: Comparative efficacy of adjuvant chemotherapy in patients with Dukes' B versus Dukes' C colon cancer: results from four National Surgical Adjuvant Breast and Bowel Project adjuvant studies (C-01, C-02, C-03, and C-04). J Clin Oncol. 1999, 17 (5): 1349-55.PubMed
19.
go back to reference Morris M, Platell C, Mc Caul K, Millward M, van Hazel G, Bayliss E, Trotter J, Ransom D, Iacopetta B: Survival rates for stage II colon cancer patients treated with or without chemoyherapy in a population-based setting. Int J Colorectal Dis. 10.1007/s00384-006-0262-y. Morris M, Platell C, Mc Caul K, Millward M, van Hazel G, Bayliss E, Trotter J, Ransom D, Iacopetta B: Survival rates for stage II colon cancer patients treated with or without chemoyherapy in a population-based setting. Int J Colorectal Dis. 10.1007/s00384-006-0262-y.
20.
go back to reference Ogata Y, Torigoe S, Matono K, Sasatomi T, Ishibashi N, Shida S, Ohkita A, Mizobe T, Ikeda S, Ogou S, Ozasa H, Shirouzu K: Prognostic factors after potentially curative resection in stage II or III colon cancer. Kurume Medical Journal. 2005, 52: 67-71. 10.2739/kurumemedj.52.67.CrossRefPubMed Ogata Y, Torigoe S, Matono K, Sasatomi T, Ishibashi N, Shida S, Ohkita A, Mizobe T, Ikeda S, Ogou S, Ozasa H, Shirouzu K: Prognostic factors after potentially curative resection in stage II or III colon cancer. Kurume Medical Journal. 2005, 52: 67-71. 10.2739/kurumemedj.52.67.CrossRefPubMed
21.
go back to reference Waterston AM, Cassidy J: Adjuvant treatment strategies for early colon cancer. Drugs. 2005, 65 (14): 1935-47. 10.2165/00003495-200565140-00003.CrossRefPubMed Waterston AM, Cassidy J: Adjuvant treatment strategies for early colon cancer. Drugs. 2005, 65 (14): 1935-47. 10.2165/00003495-200565140-00003.CrossRefPubMed
22.
go back to reference O'Connell MJ, Sargent DJ, Windschitl HE, Shepherd L, Mahoney MR, Krook JE, Rayson S, Morton RF, Rowland KM, Kugler JW: Randomized clinical trial of high-dose levamisole combined with 5-fluorouracil and leucovorin as surgical adjuvant therapy for high-risk colon cancer. Clin Colorectal Cancer. 2006, 6 (2): 133-9.CrossRefPubMed O'Connell MJ, Sargent DJ, Windschitl HE, Shepherd L, Mahoney MR, Krook JE, Rayson S, Morton RF, Rowland KM, Kugler JW: Randomized clinical trial of high-dose levamisole combined with 5-fluorouracil and leucovorin as surgical adjuvant therapy for high-risk colon cancer. Clin Colorectal Cancer. 2006, 6 (2): 133-9.CrossRefPubMed
23.
go back to reference Labianca R, Mosconi S, Garassino MC: New strategies in colon cancer adjuvant therapy. Ann Oncol. 2006, 17 (Suppl 7): vii51-vii54. 10.1093/annonc/mdl951.PubMed Labianca R, Mosconi S, Garassino MC: New strategies in colon cancer adjuvant therapy. Ann Oncol. 2006, 17 (Suppl 7): vii51-vii54. 10.1093/annonc/mdl951.PubMed
24.
go back to reference Graziano F, Cascinu S: Prognostic molecular markers for planning adjuvant chemotherapy trias in Dukes' B colorectal cancer patients: how much evidence is enough?. Ann Oncol. 2003, 14 (7): 1026-38. 10.1093/annonc/mdg284.CrossRefPubMed Graziano F, Cascinu S: Prognostic molecular markers for planning adjuvant chemotherapy trias in Dukes' B colorectal cancer patients: how much evidence is enough?. Ann Oncol. 2003, 14 (7): 1026-38. 10.1093/annonc/mdg284.CrossRefPubMed
25.
go back to reference Cascinu S, Georgoulias V, Kerr D, Maughan T, Labianca R, Ychou M: Colorectal cancer in the adjuvant setting: perspectives on treatment and the role of prognostic factors. Ann Oncol. 2003, 14 (Suppl 2): ii25-ii29.PubMed Cascinu S, Georgoulias V, Kerr D, Maughan T, Labianca R, Ychou M: Colorectal cancer in the adjuvant setting: perspectives on treatment and the role of prognostic factors. Ann Oncol. 2003, 14 (Suppl 2): ii25-ii29.PubMed
26.
go back to reference Jakesz R, Steger G: Primary (preoperative, neoadjuvant) chemotherapy of colon-cancer – a therapeutic alternative?. Chirurg. 1994, 65 (6): 497-502.PubMed Jakesz R, Steger G: Primary (preoperative, neoadjuvant) chemotherapy of colon-cancer – a therapeutic alternative?. Chirurg. 1994, 65 (6): 497-502.PubMed
27.
go back to reference Nozoe T, Rikimaru T, Mori E, Okuyama T, Takahashi I: Increase in both CEA and CA19.9 in sera is an independent prognostic indicator in colorectal carcinoma. J Surg Oncol. 2006, 94: 132-137. 10.1002/jso.20577.CrossRefPubMed Nozoe T, Rikimaru T, Mori E, Okuyama T, Takahashi I: Increase in both CEA and CA19.9 in sera is an independent prognostic indicator in colorectal carcinoma. J Surg Oncol. 2006, 94: 132-137. 10.1002/jso.20577.CrossRefPubMed
28.
go back to reference Blomqvist L, Torkzad MR: Whole-body imaging with MRI or PECT/CT: the future for single-modality imaging in oncology?. JAMA. 290 (24): 3248-9. 10.1001/jama.290.24.3248. 2003 Dec 24 Blomqvist L, Torkzad MR: Whole-body imaging with MRI or PECT/CT: the future for single-modality imaging in oncology?. JAMA. 290 (24): 3248-9. 10.1001/jama.290.24.3248. 2003 Dec 24
29.
go back to reference Blomqvist L: Preoperative staging of colorectal cancer – computed tomography and magnetic resonance imaging. Scand J Surg. 2003, 92 (1): 35-43.PubMed Blomqvist L: Preoperative staging of colorectal cancer – computed tomography and magnetic resonance imaging. Scand J Surg. 2003, 92 (1): 35-43.PubMed
Metadata
Title
Evaluation of clinical, laboratory and morphologic prognostic factors in colon cancer
Authors
Michele Grande
Giovanni Milito
Grazia Maria Attinà
Federica Cadeddu
Marco Gallinella Muzi
Casimiro Nigro
Francesco Rulli
Attilio Maria Farinon
Publication date
01-12-2008
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2008
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-6-98

Other articles of this Issue 1/2008

World Journal of Surgical Oncology 1/2008 Go to the issue