title: Prognostic factors for survival after curative resection of Dukes' B colonic cancer.
abstract: OBJECTIVE
  Data on the prognostic factors for survival in patients with locally advanced, node-negative colon cancer are limited. This study aimed to determine which factors might predict survival in patients with Dukes' B (T3 or T4, N0) colon cancer.
  
  
  METHODS
  One hundred and eighty (93 male; median age 75 [range, 38-96] years) consecutive patients who had resection of a primary Dukes' B (on final histopathological analysis) colonic cancer between 1998 and 2003 were studied. No patient received neoadjuvant chemotherapy. Multivariate Cox regression modelling was used to assess the prognostic value of variables. Median follow up was 85 (60-125) months.
  
  
  RESULTS
  Thirteen (7%) patients had a perforation at presentation. The median distance from tumour to the nearest longitudinal resection margin was 6 (0.3-27) cm. One hundred and twenty-four (69%) patients had a lymph node yield of 12 or more nodes. Actual 5-year survival was 59%. On multivariate regression analysis, tumour perforation (perforation vs no perforation, 5-year survival, 23%vs 61%; hazard ratio (HR), 3.7; 95% confidence interval (CI), 1.6-8.4; P = 0.002), tumour-to-margin distance (< 5 cm vs ≥ 5 cm, 48%vs 65%; HR, 1.7; 95% CI, 1.1-2.7; P = 0.039) and older age (≥ 75 years vs < 75 years, 45%vs 72%; HR, 3; 95% CI, 1.8-5; P < 0.001) were independent significant variables.
  
  
  CONCLUSIONS
  A lymph node yield of 12 or more nodes is not a significant prognostic factor for survival after resection of Dukes' B colonic cancer. Patients with tumour perforation or limited resection have worse prognosis.
authors.affiliation: The John Goligher Colorectal Unit, The General Infirmary at Leeds, Leeds, West Yorkshire, UK. arinsaha@yahoo.com
authors.forename: A K
authors.initials: AK
authors.lastname: Saha
authors.forename: K J E
authors.initials: KJ
authors.lastname: Smith
authors.forename: H
authors.initials: H
authors.lastname: Sue-Ling
authors.forename: P M
authors.initials: PM
authors.lastname: Sagar
authors.forename: D
authors.initials: D
authors.lastname: Burke
authors.forename: P J
authors.initials: PJ
authors.lastname: Finan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models