title: Adjuvant chemotherapy for resected colon cancer: comparison of the prognostic value of tumour and patient related factors.
abstract: OBJECTIVE
  Despite proven benefits of adjuvant chemotherapy in colon cancer, outcomes remain heterogeneous. Several non-validated prognostic factors have been proposed. This study examines the prognostic value of tumour and patient factors currently included in the Numeracy and Adjuvant! models together with measures of the local and systemic inflammatory responses in patients receiving adjuvant chemotherapy for colon cancer.
  
  
  METHODS
  Three hundred and forty-eight patients underwent resection between 1997 and 2007. Of these, 76 received adjuvant chemotherapy. Chemotherapy was 5-FU based (single or combination). Variables from the Numeracy and Adjuvant! calculators were examined. The Petersen Index was used to assess other tumour characteristics considered high risk for recurrence (venous invasion, serosal involvement, surgical margin involvement and perforation through the tumour). Local inflammatory infiltrate was scored by the Jass and Klintrup criteria; the systemic inflammatory response by the Glasgow Prognostic Score (mGPS).
  
  
  RESULTS
  Median follow-up was 78 months. Chemotherapy prescription was higher in younger patients with less comorbidity or tumours with higher nodal involvement, increasing T stage and high-risk characteristics (all P < 0.05). On univariate analysis, high-risk tumour characteristics such as T stage and high-risk Petersen Index in addition to the mGPS related to survival. Only the GPS retained prognostic significance on multivariate analysis (P < 0.005).
  
  
  CONCLUSIONS
  The results of the present study showed that the components of Numeracy and Adjuvant! models and the tumour inflammatory infiltrate had inferior prognostic value compared with that of the systemic inflammatory response, as evidenced by the mGPS, in patients receiving adjuvant chemotherapy for colon cancer.
authors.affiliation: University Department of Surgery, Glasgow Royal Infirmary, Glasgow G31 2ER, UK. campbellroxburgh@doctors.net.uk
authors.forename: Campbell
authors.initials: C
authors.lastname: Roxburgh
authors.forename: Alec
authors.initials: A
authors.lastname: McDonald
authors.forename: Jonathan
authors.initials: J
authors.lastname: Salmond
authors.forename: Karin
authors.initials: K
authors.lastname: Oien
authors.forename: John
authors.initials: J
authors.lastname: Anderson
authors.forename: Ruth
authors.initials: R
authors.lastname: McKee
authors.forename: Paul
authors.initials: P
authors.lastname: Horgan
authors.forename: Donald
authors.initials: D
authors.lastname: McMillan
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis