Stage II colon cancer staging using the number of retrieved lymph nodes may be superior to current TNM staging for prognosis stratification: the Japanese study group for postoperative follow-up of colorectal cancer

2021 ◽  
Author(s):  
Shimpei Ogawa ◽  
Michio Itabashi ◽  
Yoshiko Bamba ◽  
Kimitaka Tani ◽  
Shigeki Yamaguchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Lymph Nodes ◽  
Cancer Staging ◽  
Tnm Staging ◽  
Stage Ii ◽  
Study Group ◽  
Japanese Study ◽  
Stage Ii Colon Cancer

scholarly journals Optimal number of lymph nodes to be examined in stage II colon cancer

2019 ◽  
Vol 9 (1) ◽  
pp. 42-50
Author(s):  
M. Yu. Fedyanin ◽  
A. A. Tryakin ◽  
A. A. Bulanov ◽  
S. S. Gordeev ◽  
D. V. Kuzmichev ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Nodes ◽  
Optimal Number ◽  
Stage Ii ◽  
Stage Ii Colon Cancer

scholarly journals Documenting the Natural History of Patients With Resected Stage II Adenocarcinoma of the Colon After Random Assignment to Adjuvant Treatment With Edrecolomab or Observation: Results From CALGB 9581

2011 ◽  
Vol 29 (23) ◽  
pp. 3146-3152 ◽  
Author(s):  
Donna Niedzwiecki ◽  
Monica M. Bertagnolli ◽  
Robert S. Warren ◽  
Carolyn C. Compton ◽  
Nancy E. Kemeny ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Natural History ◽  
Adjuvant Treatment ◽  
Stage Ii ◽  
Survival Outcomes ◽  
History Of ◽  
Resected Stage ◽  
Stage Ii Colon Cancer ◽  
Disease Specific

Purpose We conducted a randomized trial comparing adjuvant treatment with edrecolomab versus observation in patients with resected, low-risk, stage II colon cancer. This study also prospectively studied patient- and tumor-specific markers of treatment outcome. Patients and Methods After surgical resection, patients with stage II colon cancer were randomly assigned to either five infusions of edrecolomab at 28-day intervals or observation without adjuvant therapy. Results Final accrual included 1,738 patients; 865 patients received edrecolomab, and 873 patients were observed without adjuvant treatment. Median follow-up time was 7.9 years. There were no significant outcome differences between study arms (overall survival [OS], P = .71; disease-free survival, P = .64). The combined 5-year all-cause OS was 0.86 (95% CI, 0.84 to 0.88), and the combined 5-year disease-specific OS was 0.93 (95% CI, 0.91 to 0.94). The relationships between demographic and histopathologic factors and survival differed for all-cause and disease-specific survival outcomes, but no combined prognostic factor model was found to adequately classify patients at higher risk of recurrence or death as a result of colon cancer. Conclusion Edrecolomab did not prolong survival. Consequently, this large study with a long duration of follow-up provided unique data concerning the natural history of resected stage II colon cancer. Prognostic factors identified in previous retrospective and pooled analyses were associated with survival outcomes in this stage II patient cohort. Results from ongoing molecular marker studies may enhance our ability to determine the risk profile of these patients.

Phenotypic subtypes as a novel validated prognostic classification system for patients with colorectal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 625-625
Author(s):  
Antonia K. Roseweir ◽  
James Hugh Park ◽  
Sanne ten Hoorn ◽  
Arfon GMT Powell ◽  
Campbell SD Roxburgh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Validation Cohort ◽  
Patient Survival ◽  
Tnm Staging ◽  
Classification Systems ◽  
Stage I ◽  
Full Cohort ◽  
Cancer Specific Survival ◽  
Stage Ii Colon Cancer

625 Background: There has been enormous effort to develop a prognostic genomic classification of colorectal cancer (CRC). As a result, mismatch repair (MMR) status was established as a prognostic marker in addition to TNM-staging. Phenotypic subtypes were recently proposed that stratified patient survival, however their clinical utility had not been compared to other proposed classification systems including consensus molecular subtypes (CMS) or current prognostic markers including MMR status. Methods: Three patient cohorts, a pilot cohort of 237 stage I-III CRC patients, a validation cohort of 879 stage I-III CRC patients, and the AMC-AJCCII-90 cohort with 81 stage II colon cancer patients were utilised to investigate associations between phenotypic subtypes, MMR status, CMS and patient survival. Results: In the pilot cohort, phenotypic subtype stratified cancer-specific survival (P < 0.001). In the validation cohort, phenotypic subtype stratified overall (p = 0.003) and cancer-specific survival (CSS, p < 0.001) independent of tumour location. MMR status associated with right-sided colon cancer (p < 0.001), therefore further analysis was restricted to this subset of patient (n = 380). The immune subtype had the highest MMR deficiency (p = 0.001). Phenotypic subtype (p < 0.001) more effectively stratified CSS than MMR status (p = 0.023). Furthermore, in left-sided colon cancer (p = 0.007) and rectal cancer (p < 0.001) only phenotypic subtype stratified CSS. Phenotypic subtype and not MMR status was independently prognostic in the full cohort (p < 0.001) and right-sided colon cancer (p < 0.001). In the AMC-AJCCII-90 cohort phenotypic subtypes aligned with CMS (p < 0.001) and stratified overall survival better than CMS (p = 0.125 v p = 0.487 respectively). Conclusions: Phenotypic subtype is a more effective prognostic classification than CMS and MMR status. Phenotypic subtypes should be incorporated alongside MMR status as a clinical aid for the prognosis of patients with CRC.

Clinical utility of the systemic inflammatory response (SIR) in identifying high-risk stage II colon cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 220-220
Author(s):  
Allan Matthew Golder ◽  
Donald C. McMillan ◽  
David Mansouri ◽  
Paul G. Horgan ◽  
Campbell SD Roxburgh
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Margin Involvement ◽  
Nodal Harvest ◽  
T Stage ◽  
Emergency Presentation ◽  
Stage Ii Colon Cancer

220 Background: Surgery for TNM Stage II colon cancer is considered curative however approximately 20% of patients will have recurrence of their disease. A number of high risk pathological features guide the use of adjuvant chemotherapy. More recently the preoperative SIR has been consistently shown to have prognostic value but to date has not been utilised clinically as a high risk feature. The present study compared the influence of the SIR versus established high-risk clinical features on overall/cancer specific survival (OS/CSS). Methods: Patients in the West of Scotland undergoing curative resection for Stage II colon cancer from 2011-2015 were identified with survival updated until December 2018. Additional data was obtained from online records. Through uni/multivariate analysis (UVA/MVA) we compared the effect on survival of the SIR measured using the modified Glasgow Prognostic Score (mGPS), neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) when entered individually into a multivariate model alongside established high-risk features. Results: 982 patients were identified having had a curative resection of Stage II colon cancer. Median follow up was 61 months and there were 307 deaths during follow up. For OS: emergency presentation, T stage, adjuvant chemotherapy, nodal harvest, margin involvement, mGPS, LMR, NLR (all p≤0.001) and EMVI (p < 0.05) were significant on UVA. On MVA: age (HR 1.51), T stage (HR 1.59), nodal harvest (HR 1.67), margin involvement (HR 1.94), adjuvant chemotherapy (HR 0.47), mGPS (HR 1.38), NLR (HR 1.35) and LMR (HR 1.50) remained significant (all p < 0.05). For CSS: age, emergency presentation, T stage, margin involvement, mGPS, NLR, LMR (all p < 0.001), nodal harvest and adjuvant chemotherapy (both p < 0.05) remained significant on UVA. On MVA emergency presentation (HR 1.88), T stage (HR 2.02), margin involvement (HR 2.98), adjuvant chemotherapy (HR 0.51) and mGPS (HR 1.34) remained significant (all p < 0.05). Conclusions: The present study suggests that the SIR is an independent predictor of worse OS/CSS in Stage II colon cancer and should be considered a high risk feature in future prospective studies.

scholarly journals Impact of Diabetes Status and Medication on Presentation, Treatment, and Outcome of Stage II Colon Cancer Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Susie Bae ◽  
Hui-Li Wong ◽  
Jeanne Tie ◽  
Jayesh Desai ◽  
Kathryn Field ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Cancer Recurrence ◽  
Population Based ◽  
Stage Ii ◽  
Diabetes Status ◽  
Stage Ii Colon Cancer ◽  
Diabetes Patients

Diabetes is a risk factor for colorectal cancer and several reports suggest worse cancer-specific outcomes in diabetes patients. Recent studies in multiple tumour types indicate metformin may positively impact on cancer-specific and overall survival. A population-based series of stage II colorectal cancer patients treated and followed from 2000 to 2013 were analysed for baseline characteristics, treatment, and outcomes. 1116 patients with stage II colon cancer were identified, 55.5% were male and median age was 70.9 years (range 20.5–101.2). The diabetes patients (21.6%,n= 241) were older than nondiabetes patients (median 74.0 versus 69.6,p= 0.0001). There was no impact of diabetes on cancer presentation or pathology. Diabetes patients were less likely to receive adjuvant treatment (13.7 versus 24.8%,p= 0.002) but were equally likely to complete treatment (69.7 versus 67.7%,p= 1.00). Diabetes did not significantly impact cancer recurrence (HR = 1.07, 95% CI 0.71–1.63) or overall survival (HR = 1.23, 95% CI 0.88–1.72), adjusted for age. Diabetes medication did not impact cancer recurrence or survival. Cancer presentation and outcomes in diabetes patients are comparable to those of nondiabetes patients in those with stage II colon cancer. The effect of metformin merits further evaluation in patients with colon cancer.

Impact of comorbidities using Adult Comorbidity Evaluation-27 (ACE-27) score on survival in stage II colon cancer: Age, TNM staging, and pathological high risk-disease.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 659-659
Author(s):  
Manik A. Amin ◽  
Andrea Wang-Gillam ◽  
Benjamin R. Tan ◽  
Rama Suresh ◽  
Joel Picus ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Cox Regression ◽  
Tnm Staging ◽  
Stage Ii ◽  
Cancer Center ◽  
Cancer History ◽  
Comorbidity Score ◽  
High Risk Disease ◽  
Stage Ii Colon Cancer

659 Background: Impact of comorbidities is identified in stage III colon cancer patients (CCPs) receiving adjuvant chemotherapy (Wildes et al, PMID 21113435) but is not well defined in predicting overall survival (OS) in stage II CCPs undergoing either adjuvant treatment or observation depending upon high-risk disease. The goal of this study was to identify impact of comorbidities on OS in this potentially curable disease using ACE-27 score, which uses 27 different patient comorbid conditions has been developed and validated by Piccirrillo et al at Barnes Jewish Hospital (BJH) (PMID: 24933715). Methods: We identified stage II CCPs treated at BJH, Siteman cancer center from January 1, 1996 to October 31st, 2013 from BJH oncology data cancer registry. The primary outcome was OS, defined as the time from date of surgery to death from any cause, censored at the time of last follow-up. Patient comorbidities at diagnosis were recorded using ACE-27 score, assigning a comorbidity score of none, mild, moderate and severe to the patients. Survival analysis was done using Cox proportional hazard modelling using STATA/SE 11.2 software. Pathological high risk features such as T4 lesions, < 12 LN, perineural, lymphovascular invasion, positive margins & perforation/obstruction were identified. Results: Out of 579 stage II CCPs, 48% male and 51% were females. High risk features were identified in 45% of patients. ACE-27 comorbidity score of none (n = 146), mild (n = 229), moderate (n = 132) and severe (n = 72) was calculated. 497 patients had T3N0M0 and 82 had T4N0M0 staging. Cox regression hazard model using histological prognostic factors, age at surgery, sex, race, prior cancer history and TNM staging showed that ACE-27 score of moderate and severe were independent predictors of OS with a hazard ratio of 1.6 (95% CI 1.0-2.4), P = 0.036 and 2.5 (95% CI 1.5-4.0), P = 0.00 respectively. Conclusions: Highest commodity burden using ACE-27 comorbidity score was associated with poor OS in stage II CCPs and was independent of other prognostic risk factors including high-risk features. Treatment related mortality will be calculated in patients with high risk disease.

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