Skip to main content

Advertisement

Log in

High-risk clinicopathological features and their predictive significance in Korean patients with stage II colon cancer

  • Original Article – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

We investigated the prognostic factors for recurrence in Korean patients with stage II colon cancer and evaluated their predictive significance with 5-fluorouracil (FU)-based adjuvant chemotherapy.

Methods

We analyzed the relationship between clinicopathological features and relapse-free survival (RFS) of 716 stage II colon cancer patients who underwent curative resection. Predictive values were assessed using 5-year RFS and 5-year cancer-specific survival (CSS).

Results

The 5-year RFS, 5-year CSS, 5-year disease-free survival, and 5-year overall survival rates were 87.4, 94.9, 84.8, and 90.5 %, respectively. T4 stage (hazard ratio [HR], 2.342; 95 % confidence interval [CI], 1.348–4.068; p = 0.003), preoperative bowel obstruction or perforation (HR 2.428; 95 % CI 1.241–4.752; p = 0.010), and age older than 70 years (HR 1.740; 95 % CI 1.130–2.678; p = 0.012) were poor prognostic factors for recurrence in multiple Cox regression analyses. In 60 patients with T4 disease, 5-FU-based adjuvant chemotherapy was associated with improved 5-year CSS of the patients (90.3 vs. 46.7 %; HR 0.135; 95 % CI 0.035–0.517; p = 0.003).

Conclusions

We found discordance between the risk factors for recurrence and the predictive value for 5-FU-based adjuvant chemotherapy in Korean patients with stage II colon cancer. Future prospective clinical trials selectively targeting high-risk patients are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Andre T, Boni C, Mounedji-Boudiaf L et al (2004) Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 350(23):2343–2351

    Article  CAS  PubMed  Google Scholar 

  • Benson AB 3rd, Schrag D, Somerfield MR et al (2004) American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol 22(16):3408–3419

    Article  PubMed  Google Scholar 

  • Bockelman C, Engelmann BE, Kaprio T, Hansen TF, Glimelius B (2015) Risk of recurrence in patients with colon cancer stage II and III: a systematic review and meta-analysis of recent literature. Acta Oncol 54(1):5–16

    Article  PubMed  Google Scholar 

  • Erlichman C, O’Connell M, Kahn M, Marsoni S, Torri V, Tardio B, Zaniboni A, Pancera G, Martignoni G, Labianca R (1999) Efficacy of adjuvant fluorouracil and folinic acid in B2 colon cancer. J Clin Oncol 17(5):1356–1363

    Google Scholar 

  • Fang SH, Efron JE, Berho ME, Wexner SD (2014) Dilemma of stage II colon cancer and decision making for adjuvant chemotherapy. J Am Coll Surg 219(5):1056–1069

    Article  PubMed  Google Scholar 

  • Figueredo A, Charette ML, Maroun J, Brouwers MC, Zuraw L (2004) Adjuvant therapy for stage II colon cancer: a systematic review from the Cancer Care Ontario Program in evidence-based care’s gastrointestinal cancer disease site group. J Clin Oncol 22(16):3395–3407

    Article  PubMed  Google Scholar 

  • Jung KW, Won YJ, Kong HJ, Oh CM, Lee DH, Lee JS (2014) Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2011. Cancer Res Treat 46(2):109–123

    Article  PubMed  PubMed Central  Google Scholar 

  • Kim GM, Ahn JB, Rha SY et al (2013) Changing treatment patterns in elderly patients with resectable colon cancer. Asia Pac J Clin Oncol 9(3):265–272

    Article  PubMed  Google Scholar 

  • Kumar A, Kennecke HF, Renouf DJ, Lim HJ, Gill S, Woods R, Speers C, Cheung WY (2014) Adjuvant chemotherapy use and outcomes of patients with high-risk versus low-risk stage II colon cancer. Cancer. doi:10.1002/cncr.29072

    Google Scholar 

  • Labianca R, Nordlinger B, Beretta GD, Mosconi S, Mandala M, Cervantes A, Arnold D, Group EGW (2013) Early colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 24(Suppl 6):vi64–vi72

  • Lin HH, Chang YY, Lin JK et al (2014) The role of adjuvant chemotherapy in stage II colorectal cancer patients. Int J Colorectal Dis 29(10):1237–1243

    Article  PubMed  Google Scholar 

  • Ma BB, Hui EP, Mok TS (2010) Population-based differences in treatment outcome following anticancer drug therapies. Lancet Oncol 11(1):75–84

    Article  PubMed  Google Scholar 

  • NCCN (2016) National Comprehensive Cancer Network clinical practice guidelines in oncology: colon cancer. http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf. Accessed 28 Feb 2016

  • Nedrebo BS, Soreide K, Nesbakken A, Eriksen MT, Soreide JA, Korner H, Norwegian Colorectal Cancer G (2013) Risk factors associated with poor lymph node harvest after colon cancer surgery in a national cohort. Colorectal Dis 15(6):e301–e308

    Article  CAS  PubMed  Google Scholar 

  • O’Connell MJ, Mailliard JA, Kahn MJ, Macdonald JS, Haller DG, Mayer RJ, Wieand HS (1997) Controlled trial of fluorouracil and low-dose leucovorin given for 6 months as postoperative adjuvant therapy for colon cancer. J Clin Oncol 15(1):246–250

    PubMed  Google Scholar 

  • O’Connell JB, Maggard MA, Ko CY (2004) Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst 96(19):1420–1425

    Article  PubMed  Google Scholar 

  • O’Connell MJ, Campbell ME, Goldberg RM, Grothey A, Seitz JF, Benedetti JK, Andre T, Haller DG, Sargent DJ (2008) Survival following recurrence in stage II and III colon cancer: findings from the ACCENT data set. J Clin Oncol 26(14):2336–2341

    Article  PubMed  Google Scholar 

  • O’Connor ES, Greenblatt DY, LoConte NK, Gangnon RE, Liou JI, Heise CP, Smith MA (2011) Adjuvant chemotherapy for stage II colon cancer with poor prognostic features. J Clin Oncol 29(25):3381–3388

    Article  PubMed  PubMed Central  Google Scholar 

  • Ogata Y, Murakami H, Sasatomi T, Ishibashi N, Mori S, Ushijima M, Akagi Y, Shirouzu K (2009) Elevated preoperative serum carcinoembrionic antigen level may be an effective indicator for needing adjuvant chemotherapy after potentially curative resection of stage II colon cancer. J Surg Oncol 99(1):65–70

    Article  PubMed  Google Scholar 

  • Punt CJ, Buyse M, Kohne CH, Hohenberger P, Labianca R, Schmoll HJ, Pahlman L, Sobrero A, Douillard JY (2007) Endpoints in adjuvant treatment trials: a systematic review of the literature in colon cancer and proposed definitions for future trials. J Natl Cancer Inst 99(13):998–1003

    Article  PubMed  Google Scholar 

  • Quah HM, Chou JF, Gonen M et al (2008) Identification of patients with high-risk stage II colon cancer for adjuvant therapy. Dis Colon Rectum 51(5):503–507

    Article  PubMed  Google Scholar 

  • Quasar Collaborative G, Gray R, Barnwell J, McConkey C, Hills RK, Williams NS, Kerr DJ (2007) Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet 370(9604):2020–2029

    Article  Google Scholar 

  • Siegel R, Ma J, Zou Z (2014) Jemal A (2014) Cancer statistics. CA Cancer J Clin 64(1):9–29

    Article  PubMed  Google Scholar 

  • Twelves C, Wong A, Nowacki MP et al (2005) Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med 352(26):2696–2704

    Article  CAS  PubMed  Google Scholar 

  • Wolmark N, Fisher B, Wieand HS et al (1984) The prognostic significance of preoperative carcinoembryonic antigen levels in colorectal cancer. Results from NSABP (National Surgical Adjuvant Breast and Bowel Project) clinical trials. Ann Surg 199(4):375–382

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wright FC, Law CH, Berry S, Smith AJ (2009) Clinically important aspects of lymph node assessment in colon cancer. J Surg Oncol 99(4):248–255

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful for the support provided by a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (Grant Number 0405-BC01-0604-0002).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hyun Cheol Chung.

Ethics declarations

Conflict of interest

The authors have declared no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, J.S., Chon, H.J., Jeung, HC. et al. High-risk clinicopathological features and their predictive significance in Korean patients with stage II colon cancer. J Cancer Res Clin Oncol 142, 2051–2059 (2016). https://doi.org/10.1007/s00432-016-2208-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-016-2208-2

Keywords

Navigation