Identification of risk factors associated with stage III disease in non-metastatic colon cancer: Results from a prospective national cohort study

• Published in: Annals of coloproctology 2020-02
• Main Authors: Lykke, Jakob, Roikjaer, Ole, Jess, Per, Rosenberg, Jacob
• Format: Article
• Language: English
• ISSN: 2287-9714
• DOI: 10.3393/ac.2019.03.03

The study aimed to, identify possible patient and tumor-related factors associated whit the risk of stage III disease in non-metastatic colon cancer. The association between stage III disease and age, sex, lymph node yield, pathologic T (pT) stage, tumor subsite, type of surgery and priority of surgery was assessed in a nationwide cohort of 13,766 patients treated by curative resection of colon cancer. Each level of age, lymph node yield and pT stage was compared to the preceding level. Age, lymph node yield, pT stage, tumor sub site and priority of surgery were associated with stage III disease. Odds ratios (OR) were as follow: Age: 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), 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), pT3/ pT4: 0.49 (95% CI: 0.47-0.54). Only tumors of the transverse colon were independently associated with a 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). 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 not right sided location, compared with stage I and II cancers.