title: Tumor size predicts long-term survival in colon cancer: an analysis of the National Cancer Data Base.
abstract: BACKGROUND
  American Joint Committee on Cancer uses tumor size for "T" staging of many solid tumors for its effect on prognosis. However, tumor size has not been incorporated in tumor (T), nodal status (N), metastasis (M) staging for colon cancer. Hence, the National Cancer Data Base was used to determine whether tumor size correlates with TNM staging and survival.
  
  
  METHODS
  For the 300,386 patients, tumor size was divided into S1 (0 to 2 cm), S2 (>2 to 4 cm), S3 (>4 to 6 cm), and S4 (>6 cm). Statistical comparison was done for TNM stage, grade, and nodal status with tumor size. Kaplan-Meier survival analysis was done for each "S" stage.
  
  
  RESULTS
  Of the 300,386 patients, 13% were classified as S1, 39% S2, 30% S3 and 18% as S4. Right colon was the most common site (48%). Tumor size positively correlated with grade, T stage, and nodal stage. Tumor size was inversely associated with survival.
  
  
  CONCLUSIONS
  Tumor size is positively correlated with important prognostic factors and negatively impacted survival.
authors.affiliation: Department of Surgery, McLaren Regional Medical Center, Flint, MI 48532, USA. Electronic address: ssahadr@aol.com.
authors.forename: Sukamal
authors.initials: S
authors.lastname: Saha
authors.affiliation: Division of Hematology/Oncology, Michigan State University, East Lansing, MI, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shaik
authors.affiliation: Department of Surgery, McLaren Macomb, Mount Clemens, MI, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Johnston
authors.affiliation: Department of Hematology/Oncology, Massachusettes General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Supriya Kumar
authors.initials: SK
authors.lastname: Saha
authors.affiliation: Department of Surgery, McLaren Regional Medical Center, Flint, MI 48532, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Berbiglia
authors.affiliation: Department of Surgery, McLaren Regional Medical Center, Flint, MI 48532, USA.
authors.forename: Micheal
authors.initials: M
authors.lastname: Hicks
authors.affiliation: Department of Surgery, McLaren Regional Medical Center, Flint, MI 48532, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Gernand
authors.affiliation: McLaren Regional Medical Center, Department of Hematology/Oncology, Flint, MI 48532, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Grewal
authors.affiliation: McLaren Regional Medical Center, Department of Hematology/Oncology, Flint, MI 48532, USA.
authors.forename: Madan
authors.initials: M
authors.lastname: Arora
authors.affiliation: McLaren Regional Medical Center, Department of Pathology, Flint, MI 48532, USA.
authors.forename: David
authors.initials: D
authors.lastname: Wiese
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Colon cancer; Overall survival; Prognostic significance; Staging; Tumor size