International Journal of Colorectal Disease

, Volume 30, Issue 9, pp 1173–1183 | Cite as

A prognostic analysis of 895 cases of stage III colon cancer in different colon subsites

  • Yan Zhang
  • Junli Ma
  • Sai Zhang
  • Ganlu Deng
  • Xiaoling Wu
  • Jingxuan He
  • Haiping Pei
  • Hong Shen
  • Shan Zeng
Original Article

Abstract

Purpose

Stage III colon cancer is currently treated as an entity with a unified therapeutic principle. The aim of the retrospective study is to explore the clinicopathological characteristics and outcomes of site-specific stage III colon cancers and the influences of tumor location on prognosis.

Methods

Eight hundred ninety-five patients with stage III colon cancer treated with radical operation and subsequent adjuvant chemotherapy (5-fluorouracil/oxaliplatin) were divided into seven groups according to colon segment (cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, and sigmoid colon). Expression of excision repair cross-complementing group 1 (ERCC1) and thymidylate synthase (TS) was examined by immunohistochemistry. We assessed if differences exist in patient characteristics and clinic outcomes between the seven groups.

Results

There were significant differences in tumor differentiation (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) stage (P < 0.001), metachronous liver metastasis (P < 0.001), metachronous lung metastasis (P < 0.001), and ERCCI expression (P < 0.001) between the seven groups. Both 5-year recurrence-free survival (RFS) and 5-year overall survival (OS) exhibited significant differences (both P < 0.001) with survival gradually decreasing from cecum to sigmoid colon. Cox regression analyses identified that tumor location was an independent prognostic factor for RFS and OS.

Conclusions

Stage III colon cancer located proximally carried a poorer survival than that located distally. Different efficacies of FOLFOX adjuvant chemotherapy may be an important factor affecting survival of site-specific stage III colon cancers.

Keywords

Colon cancer Stage III Clinical characteristics Prognosis Tumor location 

Supplementary material

384_2015_2273_MOESM1_ESM.pdf (597 kb)
Online Resource 1(PDF 597 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Yan Zhang
    • 1
    • 2
  • Junli Ma
    • 1
    • 2
  • Sai Zhang
    • 2
  • Ganlu Deng
    • 2
  • Xiaoling Wu
    • 2
  • Jingxuan He
    • 2
  • Haiping Pei
    • 3
  • Hong Shen
    • 2
  • Shan Zeng
    • 1
  1. 1.Department of Oncology, Xiangya HospitalCentral South UniversityChangshaChina
  2. 2.Institute of Medical Sciences, Xiangya HospitalCentral South UniversityChangshaChina
  3. 3.Department of Gastrointestinal Surgery, Xiangya HospitalCentral South UniversityChangshaChina

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