High-risk clinicopathological features and their predictive significance in Korean patients with stage II colon cancer.

PURPOSE

We investigated the prognostic factors for recurrence in Korean patients with stage II colon cancer and evaluated their predictive significance with 5-fluorouracil (FU)-based adjuvant chemotherapy.

METHODS

We analyzed the relationship between clinicopathological features and relapse-free survival (RFS) of 716 stage II colon cancer patients who underwent curative resection. Predictive values were assessed using 5-year RFS and 5-year cancer-specific survival (CSS).

RESULTS

The 5-year RFS, 5-year CSS, 5-year disease-free survival, and 5-year overall survival rates were 87.4, 94.9, 84.8, and 90.5 %, respectively. T4 stage (hazard ratio [HR], 2.342; 95 % confidence interval [CI], 1.348-4.068; p = 0.003), preoperative bowel obstruction or perforation (HR 2.428; 95 % CI 1.241-4.752; p = 0.010), and age older than 70 years (HR 1.740; 95 % CI 1.130-2.678; p = 0.012) were poor prognostic factors for recurrence in multiple Cox regression analyses. In 60 patients with T4 disease, 5-FU-based adjuvant chemotherapy was associated with improved 5-year CSS of the patients (90.3 vs. 46.7 %; HR 0.135; 95 % CI 0.035-0.517; p = 0.003).

CONCLUSIONS

We found discordance between the risk factors for recurrence and the predictive value for 5-FU-based adjuvant chemotherapy in Korean patients with stage II colon cancer. Future prospective clinical trials selectively targeting high-risk patients are needed.