1Department of Surgery, Institute of Innovative Cancer Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Pathology, Institute of Innovative Cancer Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3School of Life Science, Kyungpook National University, Daegu, Korea
Copyright © 2019 by the Korean Cancer Association
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Values are presented as number (%) or mean±standard deviation unless otherwise indicated. ENE, extranodal extension; s-CEA, serum carcinoembryonic antigen; RC, right colon; LC, left colon; WD, well-differentiated; MD, moderately differentiated; PD, poorly differentiated; SRC, signet ring cell; Muc, mucinous; LVI, lymphovascular invasion; PNI, perineural invasion; CTx, chemotherapy.
DFS, disease-free survival; CI, confidence interval; s-CEA, serum carcinoembryonic antigen; WD, well-differentiated; MD, moderately differentiated; PD, poorly differentiated; Muc, mucinous; SRC, signet ring cell; RC, right colon; LC, left colon; ENE, extranodal extension; LVI, lymphovascular invasion; PNI, perineural invasion; CTx, chemotherapy; CRM, circumferential resection margin.
Colon cancer (n=1,363) |
Rectal cancer (n=983) |
|||||
---|---|---|---|---|---|---|
ENE (–) (n=812) | ENE (+) (n=551) | p-value | ENE (–) (n=504) | ENE (+) (n=479) | p-value | |
Sex | ||||||
Male | 476 (58.6) | 299 (54.3) | 0.111 | 313 (62.1) | 301 (62.8) | 0.812 |
Female | 336 (41.4) | 252 (45.7) | 191 (37.9) | 178 (37.2) | ||
Age (yr) | 61±11 | 60±11 | 0.051 | 60±11 | 59±11 | 0.042 |
s-CEA level (ng/mL) | 8.0±36.7 | 9.5±39.2 | 0.480 | 5.5± 12.7 | 6.2±15.0 | 0.385 |
Tumor location | ||||||
RC | 333 (41.0) | 195 (35.4) | 0.037 | |||
LC | 479 (59.0) | 356 (64.6) | ||||
pT category | ||||||
T1 | 45 (5.6) | 10 (1.8) | 0.001 | 40 (7.9) | 12 (2.5) | < 0.001 |
T2 | 63 (7.8) | 32 (5.8) | 82 (16.3) | 41 (8.6) | ||
T3 | 645 (79.7) | 457 (83.1) | 368 (73.0) | 400 (83.7) | ||
T4 | 56 (6.9) | 51 (9.3) | 14 (2.8) | 25 (5.2) | ||
pN category | ||||||
N1 | 674 (83.0) | 314 (57.0) | < 0.001 | 409 (81.2) | 231 (48.2) | < 0.001 |
N2 | 138 (17.0) | 237 (43.0) | 95 (18.8) | 248 (51.8) | ||
pStage | ||||||
IIIA | 101 (12.4) | 32 (5.8) | < 0.001 | 111 (22.0) | 36 (7.5) | < 0.001 |
IIIB | 658 (81.0) | 391 (71.0) | 353 (71.0) | 309 (64.5) | ||
IIIC | 53 (6.5) | 128 (23.2) | 40 (7.9) | 134 (28.0) | ||
Histology | ||||||
WD/MD | 727 (89.5) | 484 (87.8) | 0.330 | 468 (92.9) | 433 (90.4) | 0.163 |
PD/SRC/Muc | 85 (10.5) | 67 (12.2) | 36 (7.1) | 46 (9.6) | ||
LVI | ||||||
No | 519 (63.9) | 322 (58.4) | 0.037 | 338 (67.1) | 253 (52.8) | < 0.001 |
Yes | 290 (35.7) | 229 (41.6) | 166 (32.9) | 226 (47.2) | ||
Unknown | 3 (0.4) | 0 | ||||
PNI | ||||||
No | 637 (78.4) | 379 (68.8) | < 0.001 | 393 (78.0) | 340 (71.0) | 0.001 |
Yes | 168 (20.7) | 163 (29.6) | 94 (18.7) | 132 (27.6) | ||
Unknown | 7 (0.9) | 9 (1.6) | 17 (3.4) | 7 (1.5) | ||
Adjuvant CTx | ||||||
Yes | 729 (89.8) | 489 (88.7) | 0.545 | 425 (84.3) | 409 (85.4) | 0.643 |
No | 83 (10.2) | 62 (11.3) | 79 (15.7) | 70 (14.6) | ||
Recurrence | 140 (17.2) | 160 (29.0) | < 0.001 | 98 (19.4) | 161 (33.6) | < 0.001 |
Follow-up, median (range, mo) | 61.7 (0.2-154.5) | 60.8 (0.7-152.4) | 63.4 (0.3-154.1) | 59.9 (0.5-151.0) |
Variable | Univariate analysis |
Multivariate analysis |
||||
---|---|---|---|---|---|---|
No. (%) | 5-Year DFS rate | p-value | Hazard ratio | 95% CI | p-value | |
Colon cancer (n=1,363) | ||||||
Age (yr) | ||||||
< 60 | 613 (45.0) | 78.2 | 0.083 | 1 | 0.173 | |
≥ 60 | 750 (55.0) | 73.3 | 1.180 | 0.930-1.531 | ||
Sex | ||||||
Female | 588 (43.1) | 76.1 | 0.862 | - | - | |
Male | 775 (56.9) | 75.3 | - | - | ||
s-CEA | ||||||
Normal | 1,070 (78.5) | 77.4 | 0.006 | 1 | 0.196 | |
High | 289 (21.2) | 69.0 | 1.184 | 0.916-1.531 | ||
Histology | ||||||
WD/MD | 1,211 (88.8) | 76.4 | 0.191 | - | - | |
PD/Muc/SRC | 152 (11.2) | 70.0 | - | - | ||
Tumor location | ||||||
RC | 528 (38.7) | 75.0 | 0.349 | - | - | |
LC | 835 (61.3) | 76.2 | - | - | ||
pStage | ||||||
Stage IIIA | 133 (9.8) | 93.3 | < 0.001 | 1 | 0.002 | |
Stage IIIB | 1,049 (77.0) | 76.1 | 3.125 | 1.535-6.362 | ||
Stage IIIC | 181 (13.2) | 60.5 | 3.930 | 1.837-8.406 | ||
ENE | ||||||
Negative | 812 (59.6) | 80.5 | < 0.001 | 1 | 0.001 | |
Positive | 551 (40.4) | 68.6 | 1.490 | 1.180-1.882 | ||
LVI | ||||||
Negative | 841 (61.7) | 80.2 | < 0.001 | 1 | 0.001 | |
Positive | 519 (38.1) | 68.0 | 1.479 | 1.170-1.870 | ||
PNI | ||||||
Negative | 1,016 (74.5) | 79.9 | < 0.001 | 1 | < 0.001 | |
Positive | 331 (24.3) | 62.3 | 1.624 | 1.275-2.068 | ||
Adjuvant CTx | ||||||
No | 145 (10.6) | 60.8 | < 0.001 | 1 | < 0.001 | |
Yes | 1,218 (89.4) | 77.3 | 0.529 | 0.383-0.731 | ||
Rectal cancer (n=983) | ||||||
Age (yr) | ||||||
< 60 | 471 (47.9) | 72.6 | 0.236 | - | - | |
≥ 60 | 512 (52.1) | 68.9 | - | - | ||
Sex | ||||||
Female | 369 (37.5) | 71.5 | 0.674 | - | - | |
Male | 614 (62.5) | 70.3 | - | - | ||
s-CEA | ||||||
Normal | 785 (79.9) | 72.2 | 0.025 | 1 | 0.559 | |
High | 197 (20.1) | 64.2 | 1.089 | 0.818-1.451 | ||
Histology | ||||||
WD/MD | 901 (91.6) | 71.4 | 0.162 | - | - | |
PD/Muc/SRC | 82 (9.4) | 64.8 | - | - | ||
pStage | ||||||
Stage IIIA | 147 (15.0) | 91.2 | < 0.001 | 1 | < 0.001 | |
Stage IIIB | 662 (67.3) | 70.6 | 3.012 | 1.663-5.456 | ||
Stage IIIC | 174 (17.7) | 54.0 | 3.778 | 1.991-7.169 | ||
ENE | ||||||
Negative | 504 (51.3) | 77.4 | < 0.001 | 1 | 0.014 | |
Positive | 479 (48.7) | 64.1 | 1.383 | 1.067-1.792 | ||
LVI | ||||||
Negative | 591 (60.1) | 77.4 | < 0.001 | 1 | 0.002 | |
Positive | 392 (39.9) | 60.8 | 1.519 | 1.166-1.980 | ||
PNI | ||||||
Negative | 733 (74.6) | 76.0 | < 0.001 | 1 | 0.001 | |
Positive | 226 (23.0) | 54.6 | 1.594 | 1.225-2.075 | ||
CRM | ||||||
Negative | 932 (94.8) | 71.8 | 0.005 | 1 | 0.165 | |
Positive | 51 (5.2) | 54.3 | 1.368 | 0.879-2.130 | ||
Adjuvant CTx | ||||||
No | 149 (15.2) | 62.0 | 0.007 | 1 | 0.005 | |
Yes | 834 (84.8) | 72.2 | 0.627 | 0.453-0.868 |
Colon cancer (n=296) |
Rectal cancer (n=258) |
|||||
---|---|---|---|---|---|---|
ENE (–) (n=137) | ENE (+) (n=159) | p-value | ENE (–) (n=98) | ENE (+) (n=161) | p-value | |
Hematogenous | 77 (56.2) | 75 (47.2) | 0.121 | 70 (71.4) | 98 (60.9) | 0.084 |
Lymph node | 26 (19.0) | 41 (25.8) | 0.163 | 17 (17.3) | 31 (19.3) | 0.702 |
Peritoneal seeding | 17 (12.4) | 23 (14.5) | 0.606 | 4 (4.1) | 8 (5.0) | 0.742 |
Multiple route | 11 (8.0) | 17 (10.7) | 0.435 | 2 (2.0) | 14 (5.4) | 0.168 |
Values are presented as number (%) or mean±standard deviation unless otherwise indicated. ENE, extranodal extension; s-CEA, serum carcinoembryonic antigen; RC, right colon; LC, left colon; WD, well-differentiated; MD, moderately differentiated; PD, poorly differentiated; SRC, signet ring cell; Muc, mucinous; LVI, lymphovascular invasion; PNI, perineural invasion; CTx, chemotherapy.
DFS, disease-free survival; CI, confidence interval; s-CEA, serum carcinoembryonic antigen; WD, well-differentiated; MD, moderately differentiated; PD, poorly differentiated; Muc, mucinous; SRC, signet ring cell; RC, right colon; LC, left colon; ENE, extranodal extension; LVI, lymphovascular invasion; PNI, perineural invasion; CTx, chemotherapy; CRM, circumferential resection margin.
Values are presented as number (%). ENE, extranodal extension.