Wang L, Gu J, Peng YF. Prognostic factors of stage Ⅱa colon cancer.
Shijie Huaren Xiaohua Zazhi 2012;
20:3816-3821. [DOI:
10.11569/wcjd.v20.i36.3816]
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Abstract
AIM: To investigate the prognostic factors of stage Ⅱa (pT3N0M0) colon cancer.
METHODS: The demographic, clinical and laboratory data for 161 patients with stage Ⅱa colon cancer treated with curative surgery alone at Peking University Cancer Hospital from January 2004 to June 2008 were reviewed retrospectively. Eighty-four valid cases were selected in this study based on inclusive and exclusive criteria. The 3-year disease-free survival (DFS) was tested by univariate and multivariate analyses to identify prognostic factors.
RESULTS: The overall 3-year DFS for the selected 84 cases was 88.1%. The 3-year DFS for patients with elevated CEA levels was significantly lower than those with normal CEA levels (76.5% vs 95.8%, P = 0.007). Multivariate analysis demonstrated that CEA level (OR = 8.013, 95% CI 1.573-40.817, P = 0.012), expression of Ki67 (OR = 3.298, 95% CI 0.799-13.610, P = 0.099), male gender (OR = 7.212, 95% CI 1.293-40.237, P = 0.024) and anemia (OR = 6.461, 95% CI 1.537-27.151, P = 0.011) were independent prognostic factors for the 3-year DFS. Stratified analysis revealed that elevated level of CEA combined with high expression of Ki67 was associated with a poorer prognosis (3-year DFS = 70%).
CONCLUSION: Elevated preoperative serum level of CEA and high expression of Ki67 in cancer tissue are predictors of poor prognosis for stage Ⅱa colon cancer. More intensive adjuvant treatment should be considered in patients with such high risk factors.
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