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World Journal of Surgery

, Volume 40, Issue 4, pp 1002–1009 | Cite as

Survival in Resected Stage II Colorectal Cancer Is Dependent on Tumor Depth, Vascular Invasion, Postoperative CEA Level, and The Number of Examined Lymph Nodes

  • Hsiang-Lin Tsai
  • Ching-Wen Huang
  • Chao-Wen Chen
  • Yung-Sung Yeh
  • Cheng-Jen Ma
  • Jaw-Yuan WangEmail author
Original Scientific Report

Abstract

Background

The aim of the present study was to determine which aspects of tumor histology influence postoperative early relapse and overall survival rates after radical resection of stage II colorectal cancer (CRC).

Methods

Data were collected for 425 patients with stage II CRC who began treatment at a single institution between January 2006 and October 2013. All the enrolled patients were followed up on until death or until December 2014. Clinically significant factors affecting postoperative early relapse and overall survival rates were analyzed.

Results

Using a multivariate analysis, tumor invasion depth (P = 0.008), vascular invasion (P = 0.029), postoperative carcinoembryonic antigen (CEA) level (P = 0.001), and retrieval of less than 12 lymph nodes (P = 0.002) were found to be independent predictors for postoperative early relapse. A combination of tumor invasion depth, vascular invasion, postoperative CEA level, and number of lymph nodes retrieved showed that the greater the number of predictors involved, the higher the likelihood of postoperative early relapse and the poorer the overall survival.

Conclusions

This study revealed that T4 invasion, vascular invasion, postoperative CEA level, and the number of examined lymph nodes may significantly affect the prognosis of stage II CRC patients after radical resection. The risks of postoperative early relapse and worse clinical outcome increase in proportion to the values of these four parameters.

Keywords

Vascular Invasion Perineural Invasion Early Relapse Examine Lymph Node Tumor Invasion Depth 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

This work was supported by Grants from the Excellence for Cancer Research Center (MOST104-2325-B-037-001); the Ministry of Health and Welfare (MOHW 104-TDU-B-212-124-003), Taiwan, Republic of China; Kaohsiung Medical University Hospital (KMUH100-OM16, KMUH103-3R16, KMUHS10304, KMUHS10305); the Center for Biomarkers and Biotech Drugs, Kaohsiung Medical University (KMU-TP103C00, KMU-TP103C03, KMU-TP103C07, KMU-TP103H11, KMU-TP104A11); and the Grant of Biosignature in Colorectal Cancers, Academia Sinica, Taiwan.

Compliance with ethical standards

Conflict of interest

The authors state no conflict of interest.

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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Hsiang-Lin Tsai
    • 1
    • 2
    • 3
  • Ching-Wen Huang
    • 1
    • 2
    • 4
  • Chao-Wen Chen
    • 3
    • 5
  • Yung-Sung Yeh
    • 1
    • 4
  • Cheng-Jen Ma
    • 1
    • 4
    • 6
  • Jaw-Yuan Wang
    • 1
    • 2
    • 3
    • 4
    • 6
    • 7
    Email author
  1. 1.Division of Gastroenterology and General Surgery, Department of SurgeryKaohsiung Medical University Hospital, Kaohsiung Medical UniversityKaohsiungTaiwan
  2. 2.Graduate Institute of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
  3. 3.Department of Surgery, Faculty of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
  4. 4.Division of Colorectal Surgery, Department of SurgeryKaohsiung Medical University Hospital, Kaohsiung Medical UniversityKaohsiungTaiwan
  5. 5.Department of Emergency Medicine, Faculty of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
  6. 6.Graduate Institute of Clinical Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
  7. 7.Division of Gastroenterology and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, and Center for Biomarkers and Biotech DrugsKaohsiung Medical UniversityKaohsiungTaiwan

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