title: The association between small tumor size and poor survival in T4 mucinous adenocarcinoma of colon without distant metastasis.
abstract: OBJECTIVE
  The purpose of this study was to analyze the impact of tumor size on cancer-specific survival (CSS) in patients with mucinous adenocarcinoma (MAC) of the colon, showing heavy intestinal wall invasion without distant metastasis (T4 N0-2 M0).
  
  
  METHODS
  Patients with T4N0-2M0 MAC of colon were analyzed based on data from the US Surveillance, Epidemiology, and End Results (SEER) database. Survival was analyzed using the Kaplan-Meier method, and the log-rank test was used to identify differences. Risk factors were analyzed using the Cox proportional hazard model. A preliminary analysis of T4N0-2M0 adenocarcinoma of colon patients from the SEER database is also presented.
  
  
  RESULTS
  A total of 585 patients from the SEER database were included in the analysis. The cutoff value (5.0 cm) was determined using the X-tile program. Kaplan-Meier analysis showed that tumors ≤5.0 cm had a poorer CSS compared to tumors >5.0 cm (p=0.034). Multivariate analysis indicated that tumor size is an independent prognostic factor for these patients, and compared to tumors ≤5.0 cm, tumors >5.0 cm were more likely to have better CSS (HR 0.658, 95% CI 0.506-0.854, p=0.002). Tumor size was also analyzed as a continuous variable in multivariate analysis, and CSS decreased with decreasing tumor size (HR 0.919, 95% CI 0.873-0.968, p<0.001). No significant association between tumor size and CSS was observed in patients with T4N0- 2M0 MAC of the colon.
  
  
  CONCLUSIONS
  Smaller tumor size is associated with poorer CSS in patients with T4N0-2M0 MAC of the colon.
authors.affiliation: Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.
authors.forename: Ben
authors.initials: B
authors.lastname: Huang
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
authors.forename: Mengdong
authors.initials: M
authors.lastname: Ni
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Xue
authors.forename: Guoxiang
authors.initials: G
authors.lastname: Cai
authors.forename: Sanjun
authors.initials: S
authors.lastname: Cai
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018426:SEER Program