title: Extramural extension as indicator for postoperative adjuvant chemotherapy in Stage IIA (pT3N0) colon cancer.
abstract: The usefulness of adjuvant chemotherapy (CMT) in patients with Stage IIA colon cancer remains unclear. The present study aimed to investigate extramural extension as an indicator for adjuvant CMT. Data were reviewed from 202 consecutive patients with Stage IIA colon cancer that underwent curative surgery between 1995 and 2007. The distance of the extramural extension (DEE) was measured histologically. The optimal prognostic cut-off point of the DEE for oncologic outcomes was statistically determined. The eligible surviving patients had been followed for a median period of 75 months (range: 2-210 months). Patients were subdivided into two groups according to the optimal cut-off point; DEE ≤5 mm (pT3a) and DEE >5 mm (pT3b). The pT3b was the most powerful independent risk factor for postoperative recurrence (P = 0.0324, HR: 3.04, 95% CI: 1.098-8.408), and was significantly correlated with distant metastasis (P = 0.0161 HR: 5.19, 95% CI: 1.765-15.239). The recurrence-free and cancer-specific 5-year survival rates in patients with pT3b were significantly lower than in patients with pT3a (81.5% vs. 95.4%, P = 0.0003 and 85.9% vs. 97.4%, P = 0.0007, respectively). pT3b could be an important risk factor for distant metastasis in Stage IIA colon cancer. Postoperative adjuvant CMT may be indicated for patients with pT3b.
authors: Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors: Yoshito
authors: Y
authors: Akagi
authors: Kazuo
authors: K
authors: Shirouzu
authors: Tetsushi
authors: T
authors: Kinugasa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary; D011184:Postoperative Period; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000175:diagnosis / Q000188:drug therapy
keywords: colon cancer; depth of invasion; extramural extension; risk factor
references: Ann Surg. 2006 Apr;243(4):492-8
references: 16552200
references: Clin Cancer Res. 2005 Dec 1;11(23):8332-40
references: 16322293
references: Int J Colorectal Dis. 2003 Nov;18(6):487-92
references: 12783251
references: Colorectal Dis. 2013 Apr;15(4):414-22
references: 22974322
references: Int J Cancer. 2012 Sep 1;131(5):1220-7
references: 22025276
references: J Clin Oncol. 2003 Aug 1;21(15):2912-9
references: 12885809
references: Lancet. 2007 Dec 15;370(9604):2020-9
references: 18083404
references: ANZ J Surg. 2002 Jul;72(7):483-7
references: 12123507
references: Int J Colorectal Dis. 2010 Feb;25(2):187-96
references: 19816699
references: Cancer. 2001 Sep 15;92(6):1435-43
references: 11745220
references: Dis Colon Rectum. 2003 Oct;46(10 Suppl):S32-43
references: 14530656
references: Ann Surg. 2011 Apr;253(4):704-10
references: 21475010
references: Ann Surg. 1983 Dec;198(6):743-52
references: 6357118
references: Lancet. 1990 May 5;335(8697):1055-9
references: 1691810
references: Int J Colorectal Dis. 2013 Feb;28(2):207-15
references: 22903336
references: Dis Colon Rectum. 2001 Nov;44(11):1682-8
references: 11711742
references: J Clin Oncol. 2002 Oct 1;20(19):3999-4005
references: 12351597
references: Int J Colorectal Dis. 2001 Sep;16(5):298-304
references: 11686527
references: J Clin Oncol. 2004 Aug 15;22(16):3408-19
references: 15199089
references: J Korean Soc Coloproctol. 2012 Jun;28(3):160-4
references: 22816060
references: Eur J Cancer. 2009 Nov;45(17):2992-9
references: 19682890
references: Pathol Oncol Res. 2009 Sep;15(3):527-32
references: 19172413
references: J Clin Oncol. 2009 Jul 1;27(19):3109-16
references: 19451431
references: J Surg Oncol. 2009 Jan 1;99(1):65-70
references: 18942720
references: Dis Colon Rectum. 1999 Feb;42(2):167-73
references: 10211491
references: J Clin Oncol. 1999 May;17(5):1356-63
references: 10334519
references: Cancer. 1996 Aug 15;78(4):918-26
references: 8756390
references: J Natl Cancer Inst. 2004 Oct 6;96(19):1420-5
references: 15467030
references: Ann Oncol. 2013 May;24(5):1274-82
references: 23235802
references: J Surg Oncol. 2011 Jul 1;104(1):45-52
references: 21416472