Clinical, histological, and molecular risk factors for cancer recurrence in patients with stage II colon cancer.
BACKGROUND
The assessment of risk factors of cancer recurrence in patients with stage II colon cancer (CC) is crucial. Our aim was to study the clinical, histological, and molecular features associated with 3-year disease-free survival in a series of consecutive patients with stage II CC treated in three regional digestive oncology centers.


METHODS
Clinical and histological data of all patients after curative surgery for stage II CC, treated from 2001 until 2009, were collected retrospectively. Histological samples were obtained and tested prospectively for microsatellite instability using fluorescent PCR amplification. Cox proportional hazards regression models were used to calculate P values, hazard ratios (HRs), and 95% confidence intervals (CIs).


RESULTS
Among 195 patients studied, 22 (11%) had disease recurrence during the 3-year period following diagnosis. On multivariate analysis, only low number of lymph nodes (HR=3.81, 95% CI: 1.19-12.19, P=0.02) and T4 status (HR=5.49, 95% CI: 1.06-28.43, P=0.04) were associated significantly with an increased risk of relapse.


CONCLUSIONS
In this series of stage II CC patients, only T4 status and low number of lymph nodes were independent risk factors for poor 3-year disease-free survival, suggesting that patients with these features should be considered for adjuvant chemotherapy.
aDepartment of Hepatogastroenterology, Digestive Oncology Unit, University Hospital, Nantes bDepartment of Hepatogastroenterology, University Hospital, Tours cIntegrated Center for Oncology, Angers dDepartment of Pathology & EA-4273 BIOMETADYS, University Hospital, Nantes eDepartment of Digestive Surgery, University Hospital, Nantes fInstitute of Histopathology, Nantes gDepartment of Pathology, University Hospital, Tours hDepartment of Medical Genetics, University Hospital, Nantes iIntegrated Center for Oncology, Saint Herblain, France.
Yann
Y
Touchefeu
Marie
M
Provost-Dewitte
Thierry
T
Lecomte
Alain
A
Morel
Isabelle
I
Valo
Jean-François
JF
Mosnier
Céline
C
Bossard
Juliette
J
Eugène
Emilie
E
Duchalais
Jérôme
J
Chetritt
Serge
S
Guyetant
Stéphane
S
Bézieau
Hélène
H
Senellart
Morgane
M
Caulet
Estelle
E
Cauchin
Tamara
T
Matysiak-Budnik
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000453:epidemiology; D007416:Intestinal Perforation / Q000453:epidemiology; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult