Adjuvant therapy for stage 2 colon cancer remains controversial but may be considered for patients with high-risk features.
Dr Hak-Mien Quah and colleagues from New York, USA assessed the prognostic significance of commonly reported clinicopathologic features of stage 2 colon cancer.
The research team identified high-risk patients.
|The 5-year disease-specific survival for this cohort was 91%|
|Diseases of the Colon & Rectum|
The team analyzed a prospectively maintained database of patients with colon cancer who underwent surgical treatment from 1990 to 2001 at a single specialty center.
The team identified 448 patients with Stage 2 colon cancer who had been treated by curative resection alone, without postoperative chemotherapy.
The researchers reported that the median follow-up was 53 months.
The 5-year disease-specific survival for this cohort was 91%.
Univariate and multivariate analyses identified 3 independent features that significantly affected disease-specific survival.
The 3 factors included tumor Stage T4, preoperative carcinoembryonic antigen more than 5 ng/ml, and presence of lymphovascular or perineural invasion.
The team found that the 5-year disease-specific survival for patients without any of the above poor prognostic features was 95%.
The 5-year disease-specific survival for patients with one of these poor prognostic features was 85%.
The research team noted that the 5-year disease-specific survival for patients with 2 poor prognostic features was 57%.
Dr Quah's team concluded, "Patients with Stage 2 colon cancer generally have an excellent prognosis."
"However, the presence of multiple adverse prognostic factors identifies a high-risk subgroup."
"Use of commonly reported clinicopathologic features accurately stratifies stage 2 colon cancer by disease-specific survival."
"Those identified as high-risk patients can be considered for adjuvant chemotherapy and/or enrollment in investigational trials."