Re-Evaluation of the Survival Paradox Between Stage IIB/IIC and Stage IIIA Colon Cancer

Overview

Journal Front Oncol

Specialty Oncology

Date 2020 Dec 14

PMID 33312954

Citations 12

Authors

Hongbo Li

Guangshun Fu

Wei Wei

Yong Huang

Zhenguang Wang

Tao Liang

Shuyun Tian

Honggang Chen

Wei Zhang

Affiliations

Soon will be listed here.

Abstract

Objective: We conducted this large population-based study to re-evaluate the survival paradox between stage IIB/C and stage IIIA colon cancer based on the newest staging criteria.

Methods: Colon cancer patients were recruited from the Surveillance, Epidemiology, and End Results (SEER) database using SEER*Stat software (version 8.3.4) with strict inclusion criteria. We used Chi-square test to compare categorical variables between patients diagnosed with stage IIB/IIC and stage IIIA colon cancer. Survival probabilities were then assessed using the Kaplan-Meier method. Cox proportional hazards models were used to analyze hazard ratios (HRs) and 95% confidence intervals (CIs) of clinicopathologic characteristics in stage IIB/IIC and stage IIIA colon cancer patients.

Results: In the current study, a total of 9,227 eligible colon cancer patients were collected from the SEER database between 2010 and 2015. It was found that stage IIIA had 66.4% decreased risk of colon cancer-specific mortality compared with stage IIB (HR = 0.336, 95%CI = 0.286-0.394 for stage IIIA, P < 0.001, using stage IIB as the reference) after the adjustment for other known prognostic factors. And T1N2a colon cancer had significantly lower 5-year overall survival (OS) rate compared with T2N1 disease (74.7% vs. 57.1%, P = 0.018).

Conclusions: Our study confirmed the existence of survival paradox between stage IIB/IIC and stage IIIA colon cancer based on the newest staging criteria. What is more, the subgroup analyses revealed that T1N2a had the least influence on the survival paradox. N2a colon cancer seemed to be associated with worse prognosis than T2 disease, which would give us a better understanding of tumor biology of colon cancer and be conducive to the refinement of individualized treatment regimens in stage III disease.

Citing Articles

Staging Paradox and recurrence pattern among stage IIB, IIC, and IIIA Colon cancers: a retrospective cohort study.

Liao Y, Huang J, Hung J, Huang K, Liang J Int J Colorectal Dis. 2024; 39(1):161.

PMID: 39397211 PMC: 11471697. DOI: 10.1007/s00384-024-04737-1.

Revisiting the survival paradox between stage IIB/C and IIIA colon cancer.

Yu C, Shi Z, Zhou G, Chang X Sci Rep. 2024; 14(1):22133.

PMID: 39333782 PMC: 11436827. DOI: 10.1038/s41598-024-73496-4.

The Association Between Surgical Site Infection and Prognosis of T4 Colorectal Cancer.

Koike T, Mukai M, Kishima K, Yokoyama D, Hasegawa S, Chan L Cureus. 2024; 16(8):e66138.

PMID: 39233924 PMC: 11371467. DOI: 10.7759/cureus.66138.

Incorporating Novel Technologies in Precision Oncology for Colorectal Cancer: Advancing Personalized Medicine.

Ahluwalia P, Ballur K, Leeman T, Vashisht A, Singh H, Omar N Cancers (Basel). 2024; 16(3).

PMID: 38339232 PMC: 10854941. DOI: 10.3390/cancers16030480.

Histopathology and levels of proteins in plasma associate with survival after colorectal cancer diagnosis.

Magnusson M, Agnarsson B, Jonasson J, Tryggvason T, Aeffner F, le Roux L Br J Cancer. 2023; 129(7):1142-1151.

PMID: 37596405 PMC: 10539279. DOI: 10.1038/s41416-023-02374-z.

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