Prognostic Factors for Post-Recurrence Survival in Stage II and III Colorectal Carcinoma Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Characteristics
2.2. Treatment and Follow-Up
2.3. Salvage Therapies
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Post-Recurrence Survival
3.3. Salvage Therapies
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Time | No in Risk | Cumulative Percentage with 95% CI |
---|---|---|
1 year | 56 (53.33%) | 51.04 (42.28–61.60) |
2 year | 32 (30.48%) | 28.37 (20.85–38.60) |
3 year | 20 (19.05%) | 18.24 (12.06–27.60) |
4 year | 9 (8.57%) | 8.69 (4.54–16.60) |
5 years | 7 (6.67%) | 6.51 (3.04–13.90) |
Characteristic | N (%) | Survival (Months) | Characteristic | N (%) | Survival (Months) | ||
---|---|---|---|---|---|---|---|
Median (95% CI) | Log-Rank Test | Median (95% CI) | Log-Rank Test | ||||
Age (years) | Differentiation | ||||||
Mean (SD) | 65.6 (10) | / | / | Low grade | 94 (89.5%) | 13 (11–17) | ns |
Median (Range) | 67 (20–84) | High grade | 11 (10.48%) | 11 (≥6) | |||
Age (categories) | Lymphatic invasion | ||||||
<70 yrs | 67 (63.8%) | 18 (12–29) | <0.01 | Yes | 73 (69.5%) | 7.5 (≥5) | ns |
≥70 yrs | 38 (36.2%) | 7 (5–13) | No | 14 (13.4%) | 15 (11–18) | ||
Gender | No data | 18 (17.1%) | / | ||||
Male | 44 (41.9%) | 9.5 (7–16) | <0.05 | Vascular invasion | |||
Female | 61 (58.1%) | 17 (12–25) | Yes | 44 (41.9%) | 11 (9–30) | ns | |
Localization | No | 35 (33.3%) | 14 (9–18) | ||||
Right side | 36 (34.3%) | 10 (8–14) | ns | No data | 26 (24.8%) | / | |
Left side | 69 (65.7%) | 16 (12–24) | T stage | ||||
Bowel obstruction | T2 | 4 (3.8%) | 13 (≥2) | ns | |||
Yes | 33 (31.4%) | 13 (10–29) | ns | T3 | 84 (80%) | 13 (11–18) | |
No | 72 (68.6%) | 13 (10–18) | T4a | 3 (2.9%) | 23 (≥5) | ||
Bowel perforation | T4b | 14 (13.3%) | 9 (6–50) | ||||
Yes | 12 (11.4%) | 13.5 (≥10) | ns | N stage | |||
No | 93 (88.6%) | 13 (10–18) | N0 | 10 (9.5%) | 28.5 (≥6) | ns | |
ECOG PS † | N1a | 12 (11.4%) | 20.5 (≥11) | ||||
PS0 | 89 (84.8%) | 12 (10–17) | ns | N1b | 24 (22.9%) | 16 (11–34) | |
PS1 | 16 (15.2%) | 16.5 (6–48) | N2a | 24 (22.9%) | 13 (10–24) | ||
CEA | N2b | 33 (31.4%) | 9 (7–19) | ||||
≤5 mg/mL | 86 (81.9%) | 12 (10–18) | ns | No data | 2 (1.9%) | / | |
>5 ng/mL | 16 (15.2%) | 14.5 (5–42) | Stage | ||||
No data | 3 (2.9%) | / | II | 9 (8.6%) | 47 (≥9) | <0.05 | |
Ca19-9 | III | 96 (91.4%) | 13 (10–17) | ||||
≤37 U/mL | 91 (86.7%) | 15 (11–18) | <0.01 | First recurrence | |||
>37 U/mL | 9 (8.6%) | 8 (≥4) | Local | 18 (17.1%) | 20.5 (10–42) | ns | |
No data | 5 (4.7%) | / | Systemic disease | 11 (10.5%) | 8 (≥5) | ||
Adjuvant CHT | Combined | 76 (72.4%) | 12.5 (10–17) | ||||
5FU-LV | 37 (35.2%) | 23 (11–34) | ns | Early recurrence | |||
Capecitabine | 68 (64.8%) | 11 (9–16) | <1 year | 39 (37.1%) | 11 (10–19) | ns | |
Histology | ≥1 year | 66 (62.9%) | 13 (10–23) | ||||
Adenocarcinoma | 93 (88.6%) | 15 (11–19) | <0.01 | Late recurrence | |||
Mucinous | 10 (9.5%) | 8.5 (≥6) | ≥4 years | 13 (12.4%) | 10 (≥6) | ns | |
Signet ring | 2 (1.9%) | 4 (≥1) | <4 years | 92 (87.6%) | 13.5 (12–18) |
Parameters | Univariate Cox Regression | Multivariate Cox Regression | ||
---|---|---|---|---|
HR (95% CI) | Wald Test | HR (95% CI) | Likelihood Ratio Test | |
Age ≥70 yrs vs. <70 yrs | 2.19 (1.42–3.38) | p < 0.01 | 2.43 (1.55–3.81) | p < 0.01 |
Gender Male vs. Female | 1.45 (0.96–2.19) | ns | - | |
Histology Mucinous vs. Adenocarcinoma Signet ring vs. Adenocarcinoma | 2.07 (1.02–4.20) 6.73 (1.58–28.58) | p < 0.05 p < 0.05 | 1.51 (0.73–3.10) 9.69 (2.23–42.0) | |
Clinical stage Stage III vs. Stage II | 2.64 (1.13–6.17) | p < 0.05 | - | |
Ca19–9 >37 U/ml vs. ≤37 U/mL | 2.71 (1.33–5.52) | p < 0.05 | 3.51 (1.68–7.37) |
Salvage Treatment | N (%) | Median Survival (Months) 95%CI | Log-Rank Test |
---|---|---|---|
BSC +/− local RT | 24 (22.8%) | 3 (2–5) | <0.01 |
Surgery only | 8 (7.6%) | 38.5 (23-NR) | |
Chemotherapy only | 41 (39%) | 13 (10–19) | |
Combined treatment | 24 (22.9%) | 24 (17–42) |
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Nikolic, N.; Radosavljevic, D.; Gavrilovic, D.; Nikolic, V.; Stanic, N.; Spasic, J.; Cacev, T.; Castellvi-Bel, S.; Cavic, M.; Jankovic, G. Prognostic Factors for Post-Recurrence Survival in Stage II and III Colorectal Carcinoma Patients. Medicina 2021, 57, 1108. https://doi.org/10.3390/medicina57101108
Nikolic N, Radosavljevic D, Gavrilovic D, Nikolic V, Stanic N, Spasic J, Cacev T, Castellvi-Bel S, Cavic M, Jankovic G. Prognostic Factors for Post-Recurrence Survival in Stage II and III Colorectal Carcinoma Patients. Medicina. 2021; 57(10):1108. https://doi.org/10.3390/medicina57101108
Chicago/Turabian StyleNikolic, Neda, Davorin Radosavljevic, Dusica Gavrilovic, Vladimir Nikolic, Nemanja Stanic, Jelena Spasic, Tamara Cacev, Sergi Castellvi-Bel, Milena Cavic, and Goran Jankovic. 2021. "Prognostic Factors for Post-Recurrence Survival in Stage II and III Colorectal Carcinoma Patients" Medicina 57, no. 10: 1108. https://doi.org/10.3390/medicina57101108