Clinicopathological Characteristics And Multivariate Analysis Of Prognosis Of 491 Patients With Colon Cancer

Objective & Methods:To define the prognostic factors in colon cancer patients, univariate and multivariate analysis were performed on data from 491 patients who underwent resection for colon cancer at the First Affiliated Hospital,College of Medicine,Zhejiang University.The prognostic variables used for the analysis included patient's gender,age,symptom duration,preoperative serum carcinoembryonic antigen(CEA)and carbohydrate Antigen 19-9(CA19-9)level, tumor location,tumor size,gross morphology of tumor,differentiation grade, histologic differentiation,numbers of lymph node metastases,total lymph nodes, depth of bowel wall invasion,distance metastasis,postoperative recurrence,Dukes' stage and postoperative adjuvant chemotherapy.Results:The overall 2-year survival rate was 77.1%,and disease-free survival was 69.0%.The overall 2-year survival rate on Dukes' A,B,C and D were 96.2%,92.1 %,73.2%and 24.3%,and the average survival time were(88.885±4.234),(77.204±4.023),(60.326±6.039),(22.119±5.779)months.Four groups of Dukes' C patients with lymph node metastases(≤25%,25～50%,50～75%and＞75%),the 2-year overall survival rate were 75.8%,69.4%,55.0%and 21.4%respectively,and the average survival time were(62.520±7.447),(52.134±9.220),(50.811±17.116),(23.936±10.787)months respectively.In the univariate analysis,all the factors except age,gender,tumor size,gross morphology of tumor and postoperative adjuvant chemotherapy were associated with prognosis.Among the factors significant in the univariate analysis,Dukes' stage(p=0.005),number of lymph node metastases (p=0.025),CEA level(p=0.006)and distance metastasis(p=0.000)were significant in the multivariate analysis.Conclusions:Although Dukes' stage is the most reliable prognostic predictor,this study shows that other factors(number of lymph node metastases(p=0.025),also provide important information for the outcome of the patient.For patients with Dukes' C,the higher was the rate of lymph node metastasis,the poorer the prognosis. While in patients with Dukes' A&B(lymph node-negative)colon cancer,the prognosis is positively correlated with the total numbers of examed lymph nodes.