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A prognostic analysis of 895 cases of stage III colon cancer in different colon subsites

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Stage III colon cancer is currently treated as an entity with a unified therapeutic principle. The aim of the retrospective study is to explore the clinicopathological characteristics and outcomes of site-specific stage III colon cancers and the influences of tumor location on prognosis.

Methods

Eight hundred ninety-five patients with stage III colon cancer treated with radical operation and subsequent adjuvant chemotherapy (5-fluorouracil/oxaliplatin) were divided into seven groups according to colon segment (cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, and sigmoid colon). Expression of excision repair cross-complementing group 1 (ERCC1) and thymidylate synthase (TS) was examined by immunohistochemistry. We assessed if differences exist in patient characteristics and clinic outcomes between the seven groups.

Results

There were significant differences in tumor differentiation (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), American Joint Committee on Cancer (AJCC) tumor–node–metastasis (TNM) stage (P < 0.001), metachronous liver metastasis (P < 0.001), metachronous lung metastasis (P < 0.001), and ERCCI expression (P < 0.001) between the seven groups. Both 5-year recurrence-free survival (RFS) and 5-year overall survival (OS) exhibited significant differences (both P < 0.001) with survival gradually decreasing from cecum to sigmoid colon. Cox regression analyses identified that tumor location was an independent prognostic factor for RFS and OS.

Conclusions

Stage III colon cancer located proximally carried a poorer survival than that located distally. Different efficacies of FOLFOX adjuvant chemotherapy may be an important factor affecting survival of site-specific stage III colon cancers.

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Acknowledgments

This study was supported by the grants from the National Nature Science Foundation of China (Nos. 30770971, 81172470, 81070362, and 81372629).

Conflict of interest

All authors declare no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China

    Yan Zhang, Junli Ma & Shan Zeng

  2. Institute of Medical Sciences, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China

    Yan Zhang, Junli Ma, Sai Zhang, Ganlu Deng, Xiaoling Wu, Jingxuan He & Hong Shen

  3. Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China

    Haiping Pei

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  1. Yan Zhang
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  2. Junli Ma
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  3. Sai Zhang
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  5. Xiaoling Wu
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Correspondence to Shan Zeng.

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Zhang, Y., Ma, J., Zhang, S. et al. A prognostic analysis of 895 cases of stage III colon cancer in different colon subsites. Int J Colorectal Dis 30, 1173–1183 (2015). https://doi.org/10.1007/s00384-015-2273-z

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