The Number of Risk Factors Determines the Outcome Of Stage II Colorectal Cancer Patients

BACKGROUND/AIMS: We evaluated the prognostic significance of clinicopathologic features recommended by the majority of guidelines for identifying high-risk stage it colon cancer patients.

METHODOLOGY: We enrolled 665 stage II colorectal cancer patients at Taipei Veterans General Hospital in 2002-2006. Patients who received preoperative or postoperative chemotherapy were excluded (124). The measured endpoint was disease-free survival.

RESULTS: Of 541 patients, 59 showed stage T4 tumors; 35, lymphovascular invasion; 19, poor differentiation, and 251, carcinoembryonic antigen levels of > 5 ng/mL; 53 underwent emergent operations. Colorectal cancer recurred in 84 patients. The 5-year disease-free survival rate was 84.5%. Univariate and multivariate analyses revealed 3 independent factors affecting the prognosis significantly tumor stage T4, high carcinoembryonic antigen level, and presence of lymphovascular invasion. Considering the cumulative effect of risk factors, the 5-year disease-free survival rate of patients with tumors without any risk factor was 90.2%, which was significantly better than that of patients with 1 or 2 risk factors (82.3%, 61.6%).

CONCLUSIONS: Stage II colorectal cancer patients had excellent outcome. Ad juvant chemotherapy may be warranted for patients with multiple risk factors.