Identification of Risk Factors Associated With Stage III Disease in Nonmetastatic Colon Cancer: Results From a Prospective National Cohort Study.

PURPOSE

This study aimed to identify possible patient- and tumor-related factors associated with risk of TNM stage III disease in nonmetastatic colon cancer.

METHODS

The associations between stage III disease and age, sex, lymph node yield, pathological tumor (pT) stage, tumor subsite, type of surgery, and priority of surgery were assessed in a nationwide cohort of 13,766 patients treated with curative resection of colon cancer. Each level of age, lymph node yield, and pT stage was compared to the preceding level.

RESULTS

Age, lymph node yield, pT stage, tumor subsite, and priority of surgery were associated with stage III disease. Odds ratios (95% confidence interval [CI]) were as follows: age < 65/65-75 years: 1.28 (95% CI, 1.15-1.43) and 65-75/ > 75 years: 1.22 (95% CI, 1.13-1.32); lymph node yield 0-5/6-11: 0.60 (95% CI, 0.50-0.72), lymph node yield 6-11/12-17: 0.84 (95% CI, 0.76-0.93), and lymph node yield 12-17/ ≥ 18: 0.97 (95% CI, 0.89-1.05); pT1/pT2: 0.74 (95% CI, 0.57-0.95), pT2/pT3: 0.35 (95% CI, 0.30-0.40), and pT3/pT4: 0.49 (95% CI, 0.47-0.54). Only tumors of the transverse colon were independently associated with lower risk of stage III disease than tumors in the sigmoid colon (sigmoid colon: 1, transverse colon: 0.84 [95% CI, 0.73-0.96]; elective surgery: 1, acute surgery: 1.43 [95% CI, 1.29-1.60]).

CONCLUSION

In this study, stage III disease in colon cancer was significantly associated with age, lymph node yield, pT stage, tumor subsite, and priority of surgery but was not associated with right-sided location compared with stage I and II cancers.