Prognostic value of tumor size in stage II and III colorectal cancer in Tunisian population. (December 2017)

• Record Type: Journal Article
• Authors: Mejri, Nesrine; Dridi, Manel; El Benna, Houda; Labidi, Soumaya; Daoud, Nouha; Boussen, Hamouda
• Is Part Of: Colorectal cancer. Volume 6:Number 4(2017)
• Page Start: 113
• Page End: 119
• Publication Date: 2017-12
• Subjects: colorectal cancer -- prognosis -- tumor size; Colon (Anatomy) -- Cancer -- Periodicals; Rectum -- Cancer -- Periodicals; 616.994347
• DOI: 10.2217/crc-2017-0011
• Languages: English
• ISSNs: 1758-194X

Abstract

Aim: We aimed to identify a cutoff value of tumor size (TuS) correlated to prognosis of stage II and III colorectal cancer and to evaluate the prognostic significance.Patients & methods: We retrospectively analyzed 257 patients treated for stage II–III colorectal cancer between 2003 and 2014. We used receiver-operating characteristic to evaluate TuS performance accuracy to predict survival. We identified a cutoff value. We used the Kaplan–Meier method and Cox regression analysis to study survival and prognostic factors.Results: Area under the receiver-operating characteristic curve of TuS was 0.62 ± 0.048. A size of 4 cm was identified as a predictor of survival with a sensitivity of 88.2% and a specificity of 59.2%. We observed 98 patients with TuS ≤4 cm and 159 patients with TuS greater than 4 cm. Patients with TuS greater than 4 cm were more likely to have a cancer located in the colon (81.1 vs 70.4%, p = 0.002) and commonly pT4 (44 vs 22.4%, p = 0.0001). There was no difference in terms of gender, insufficient removed lymph nodes number, number of positive lymph nodes, stage and oxaliplatin administration between both groups. 5-year survival rate of patients with TuS ≥4 cm and TuS less than 4 cm was 76 and 84%, respectively (p = 0.008). Age ≥65 years, stage III, venous invasion and pN+ greater than 3 were significant bad prognostic factors in patients with TuS ≥4 cm in univariate analysis. Stage III was the only independent prognostic factor in multivariate analysis. Administration of chemotherapy was the only factor with significant impact on survival in univariate and multivariate analyses in patients with TuS less than 4 cm.Conclusion: TuS had not only an impact on survival but also interfered with other prognostic factors.