The Latest Update Of Prognostic Factors Of Stage Iii Colon Cancer Who Underwent Curative Operation And Postoperative Adjuvant Chemotherapy

This study aimed to explore the predicting factor of the poor prognosis of stage III colon cancer. Adjuvant chemotherapy for stage III colon cancer has become popular. However, the choice of the optimal adjuvant chemotherapy regimen still remains unclear. A total of 135 patients with stage III colon cancer, treated with postoperative adjuvant chemotherapy from January 2007 to December 2012 at the Kitasato University East Hospital, were reviewed retrospectively in terms of clinicopathologic characteristics associated with survival and recurrence (median observation: 61 months). We used a multivariate Cox hazards model to identify independent prognostic factors in stage III colon cancer. Of the 135 patients, 38 had recurrence. Five-year overall survival was 83.9%, while 3-year recurrence-free survival was 72.8%. Oxaliplatin-containing adjuvant chemotherapy was almost exclusively applied to stage IIIB colon cancer. Univariate analysis of the negative prognostic factors were N2 (P = 0.0004); operation time (P = 0.0346); tumor size (P = 0.0092); depth of invasion (P = 0.005); histology (P = 0.0403); infiltration type (P, 0.0001); lymphatic permeation (ly3, P = 0.0001); and vascular permeation (v3, P = 0.0005). On multivariate analysis, the independent prognostic factors for relapse-free survival were v3 (P = 0.032) and N2 (P = 0.0216). Combination of the prognostic factors clearly stratified prognosis of stage III colon cancer patients, and those with either factor positive had a poor prognosis despite administration of adjuvant chemotherapy. Both v3 and pN2 may be critical prognostic factors in stage III colon cancer with adjuvant chemotherapy. This information would elucidate areas of concern in the present therapeutic strategy in stage III colon cancer.