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 25 May 2018

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News

Identifying patients with high-risk colon cancer for adjuvant therapy

The most recent issue of the Diseases of the Colon & Rectum identifies patients with high-risk stage 2 colon cancer for adjuvant therapy.

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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."

Dis Col Rectum 2008: 51(5): 503-7
21 May 2008

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