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Significance of Histologic Type of Primary Lesion and Metastatic Lymph Nodes as a Prognostic Factor in Stage III Colon Cancer

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Diseases of the Colon & Rectum

Purpose

This study was designed to investigate whether the histologic types of the primary lesion and of metastatic lymph nodes in Stage III colon cancer are useful as prognostic factors. The usefulness of adjuvant chemotherapy in a randomized, controlled trial by using these prognostic factors as stratification criteria was also investigated.

Methods

Stage III colon cancer patients were enrolled and were divided into two groups: Group W, in which the histologic type of both primary tumors and metastatic lymph nodes was well-differentiated adenocarcinoma; and Group U, in which the primary tumors and the metastatic lymph nodes were of any type other than well-differentiated. Group W patients were assigned to Treatment Arm A (surgery alone) or Arm B (surgery, then 1-hexylcarbamoyl-5-fluorouracil); and Group U patients, to Treatment Arm C (same as B), and Arm D (surgery + 1-hexylcarbamoyl-5-fluorouracil + mitomycin C).

Results

The Group W five-year survival rate was significantly superior to that in Group U (P = 0.0035). There was a better survival rate in Treatment Arm A than Arm B (P = 0.0321), but no difference between Treatment Arms C and D.

Conclusions

In Stage III colon cancer, the prognosis of cases whose primary lesion and lymph node tissues are both well differentiated is extremely good. In such cases, it is possible for adjuvant chemotherapy to have a deleterious effect, and therefore, it is not recommended.

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Authors and Affiliations

  1. Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Takeo Mori M.D.

  2. Department of Pathology, Tokyo Medical University, Tokyo, Japan

    Teruyuki Hirota M.D.

  3. Department of Biostatistics/School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan

    Yasuo Ohashi Ph.D.

  4. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan

    Susumu Kodaira M.D.

  5. Department of Surgery, Tokyo Metropolitan Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan

    Takeo Mori M.D.

Authors
  1. Takeo Mori M.D.
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  2. Teruyuki Hirota M.D.
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  3. Yasuo Ohashi Ph.D.
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  4. Susumu Kodaira M.D.
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Consortia

Prospective Trial of Adjuvant Chemotherapy for Colon Cancer Study Group (PAC)

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Correspondence to Takeo Mori M.D..

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Mori, T., Hirota, T., Ohashi, Y. et al. Significance of Histologic Type of Primary Lesion and Metastatic Lymph Nodes as a Prognostic Factor in Stage III Colon Cancer. Dis Colon Rectum 49, 982–992 (2006). https://doi.org/10.1007/s10350-006-0531-4

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  • DOI: https://doi.org/10.1007/s10350-006-0531-4

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