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


CONCLUSIONS
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.
Grande
Michele
M
University Hospital Tor Vergata, department of surgery, University hospital Tor Vergata, Viale Oxford, 81 00133 Rome, Italy. grande@med.uniroma2.it
Milito
Giovanni
G
Attinà
Grazia Maria
GM
Cadeddu
Federica
F
Muzi
Marco Gallinella
MG
Nigro
Casimiro
C
Rulli
Francesco
F
Farinon
Attilio Maria
AM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies
Ann Oncol. 2003;14 Suppl 2:ii25-9
12810454
Clin Colorectal Cancer. 2006 Jul;6(2):133-9
16945169
Chirurg. 1994 Jun;65(6):497-502
8088204
Cancer. 1992 Feb 1;69(3):626-35
1730115
Scand J Surg. 2003;92(1):35-43
12705549
Zhonghua Zhong Liu Za Zhi. 1986 Mar;8(2):146-8
3021418
Drugs. 2005;65(14):1935-47
16162019
JAMA. 2003 Dec 24;290(24):3248-9
14693879
Hepatogastroenterology. 2004 Jan-Feb;51(55):142-6
15011850
Cancer. 1996 Aug 1;78(3):403-8
8697383
Ann Oncol. 2006 Jun;17 Suppl 7:vii51-4
16760294
World J Gastroenterol. 2006 Mar 7;12(9):1458-62
16552821
Rom J Gastroenterol. 2002 Sep;11(3):183-9
12368937
J Clin Oncol. 1999 May;17(5):1349-55
10334518
Dis Colon Rectum. 1997 Mar;40(3):326-31
9118749
Br J Surg. 1998 Feb;85(2):236-9
9501824
Tohoku J Exp Med. 2003 Feb;199(2):85-93
12705353
Dis Colon Rectum. 2001 Nov;44(11):1682-8
11711742
Ann Oncol. 2003 Jul;14(7):1026-38
12853343
Dis Colon Rectum. 2005 Jun;48(6):1161-8
15868237
Gut. 2002 Jul;51(1):65-9
12077094
J Surg Oncol. 2006 Aug 1;94(2):132-7
16847905
Kurume Med J. 2005;52(3):67-71
16422171
Dis Colon Rectum. 2001 Feb;44(2):251-8
11227943
Dis Colon Rectum. 1988 Jan;31(1):33-41
3366023
Dis Colon Rectum. 2001 Mar;44(3):364-72; discussion 372-3
11289282
Eur J Cancer. 1995 Jul-Aug;31A(7-8):1216-21
7577025
Int J Colorectal Dis. 2007 Aug;22(8):887-95
17235506
Br J Surg. 2006 Jul;93(7):866-71
16622901