Quyen D Chu1, Meijiao Zhou2, Kaelen Medeiros2, Prakash Peddi3. 1. Department of Surgery, Louisiana State University Health Sciences Center, Shreveport, LA; Feist-Weiller Cancer Center, Shreveport, LA. Electronic address: qchu@lsuhsc.edu. 2. Louisiana Tumor Registry and Epidemiology, New Orleans, LA; School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA. 3. Division of Hematology and Oncology, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA; Feist-Weiller Cancer Center, Shreveport, LA.
Abstract
BACKGROUND: The underlying reasons for the survival paradox between stage IIB/C and stage IIIA colon cancer are elusive. We hypothesized that positive margins contribute to this paradox. METHODS: We evaluated a cohort of 16,471 patients with stage IIIA and stage IIB/C colon cancer from 709,583 cases diagnosed between 2003-2012 in the National Cancer Data Base. All patients had chemotherapy, and all stage IIB/C patients had ≥12 lymph nodes retrieved. Patients with stage IIIA were subdivided further into those with <12 lymph nodes retrieved and those with ≥12 lymph nodes retrieved. Univariable and multivariable survival analyses were used. RESULTS: The 5-year overall survival rate was 70.8% for stage IIB/C, 81.6% for stage IIIA with <12 lymph nodes, and 85.6% for stage IIIA with ≥12 lymph nodes (P < .0001). The 5-year overall survival rate was 84.3% for stage IIIA with no residual tumor, 74.8% for stage IIIA with residual tumor, 73.3% for stage IIB/C with no residual tumor, and 60.5% for stage IIB/C with residual tumor (P < .0001). Independent predictors (P < .01) of poor overall survival include stage IIB/C, advanced age, African American ethnicity, community cancer program, uninsured and Medicaid, low education level, high comorbidity index, and positive surgical margins. CONCLUSION: Positive surgical margins may contribute to the survival paradox between stage IIB/C and stage IIIA colon cancer patients.
BACKGROUND: The underlying reasons for the survival paradox between stage IIB/C and stage IIIA colon cancer are elusive. We hypothesized that positive margins contribute to this paradox. METHODS: We evaluated a cohort of 16,471 patients with stage IIIA and stage IIB/C colon cancer from 709,583 cases diagnosed between 2003-2012 in the National Cancer Data Base. All patients had chemotherapy, and all stage IIB/C patients had ≥12 lymph nodes retrieved. Patients with stage IIIA were subdivided further into those with <12 lymph nodes retrieved and those with ≥12 lymph nodes retrieved. Univariable and multivariable survival analyses were used. RESULTS: The 5-year overall survival rate was 70.8% for stage IIB/C, 81.6% for stage IIIA with <12 lymph nodes, and 85.6% for stage IIIA with ≥12 lymph nodes (P < .0001). The 5-year overall survival rate was 84.3% for stage IIIA with no residual tumor, 74.8% for stage IIIA with residual tumor, 73.3% for stage IIB/C with no residual tumor, and 60.5% for stage IIB/C with residual tumor (P < .0001). Independent predictors (P < .01) of poor overall survival include stage IIB/C, advanced age, African American ethnicity, community cancer program, uninsured and Medicaid, low education level, high comorbidity index, and positive surgical margins. CONCLUSION: Positive surgical margins may contribute to the survival paradox between stage IIB/C and stage IIIA colon cancerpatients.
Authors: Seung-Seop Yeom; Soo Young Lee; Chang Hyun Kim; Hyeong Rok Kim; Young Jin Kim Journal: Int J Colorectal Dis Date: 2019-07-10 Impact factor: 2.571
Authors: Ryan K Orosco; Viridiana J Tapia; Joseph A Califano; Bryan Clary; Ezra E W Cohen; Christopher Kane; Scott M Lippman; Karen Messer; Alfredo Molinolo; James D Murphy; John Pang; Assuntina Sacco; Kathryn R Tringale; Anne Wallace; Quyen T Nguyen Journal: Sci Rep Date: 2018-04-09 Impact factor: 4.379