The Clinicopathological And Survival Differences Between Patients With Stage Ⅱ And Stage ⅢA Colon Cancer

Objective:To explore the difference in survival prognosis between stage Ⅱ and stageⅢA colon cancer,and to analyze the factors affecting the prognosis of colon cancer.Methods:The SEER*Stat software was used to identify patients whose pathological diagnosis as colon malignancy from 2004 to 2005,and underwent surgical treatment combined with adjuvant chemotherapy.Comparisons of count date were done using chi-square test.The Kaplan-Meier was used to calculate the cumulative survival rate and draw the survival curve.The significant difference was evaluated by the log-rank test.According togender,age of diagnosis,year of diagnosis,race,histopathologic graing,number of acquired lymph nodes,histological type,specific part of the tumor and tumor size,propensity score maching(PSM)was preformed by R language(version 3.5.1),makingthe baseline data between the subgroups comparable.Univariate and Cox multivariate regression analysis were applied to evaluate the prognostic factors.Result:1、Comparison of cancer specific survival rate(CSS):The 5 year tumor specific survival rate of stage ⅢA was better than stage Ⅱ(92.5%vs.86.9%,P=0.000).After adjusting the baseline data between the subgroups by PSM:the 5 year tumor specific survival rate of stage ⅢA was still better than stage Ⅱ(92.5%vs.85.9%,P=0.000).2、The univariate analysis result showed:The age of diagnosis(X2=41.567;P=0.000),race(X2=9.620;P=0.008),histopathologic graing(X2=12.723;P=0.005),number of obtained lymph nodes(X2=18.509;P=0.000),tumor size(X2=14.359;P=0.000),Tumor specific location(X2=11.208;P=0.001),TNM staging(X2=34.731;P=0.000)influenced the CSS of the colon cancer.3、The multivariate analysis result showed:The age of diagnosis(95%CI:1.208-1.587,P=0.000),race(95%CI:1.015-1.390,P=0.032),histopathologic graing(95%C I:1.174-1.706,P=0.000),number of obtained lymph nodes(95%CI:0.454-0.703,P=0.000),tumor size(95%CI:1.358-2.357,P=0.000),Tumor specific location(95%CI:0.612-0.951,P=0.016),TNM staging(95%CI:0.429-0.663,P=0.000)were the i ndependent prognosis factors influencing the CSS of the colon cancerConclusions:1、Patients with stage ⅢA colon cancer have a higher survival rate than patients with stage Ⅱ colon cancer2、The factors of the age of diagnosis,race,histopathologic graing,number of acquired lymph nodes,tumor size,TNM staging are indicators for evaluating the survival prognosis of patients with stage Ⅱ and stage ⅢAcolon cancer undergoing surgery combined with chemotherapy.