Tech Coloproctol (2004) 8:S152–S154 DOI 10.1007/s10151-004-0141-x
S. Angelopoulos • I. Kanellos • E. Christophoridis • T. Tsachalis • A. Kanellou • D. Betsis
Five-year survival after curative resection for adenocarcinoma of the colon
Abstract Background The purpose of this study was to evaluate the 5-year survival of patients with colon adenocarcinoma that underwent elective or emergency curative surgical treatment. Patients and methods Between 1993 and 1998, 80 patients underwent a potentially curative colonic resection based on mobilisation along anatomic planes. Among the patients, 26 underwent right colectomy, 3 transverse colectomy, 13 left colectomy and 38 sigmoidectomy. All patients classified as TNM stage III
underwent adjuvant chemotherapy. The Kaplan–Meier method was used to analyse survival. Results Overall 5year survival was 69.5%. Patient’s sex and age, mucinous characteristics of the tumour and tumour location did not significantly affect survival. Patients with higher Duke’s classification and TNM stage had significantly worse 5year survival (p=0.025 and p=0.007, respectively). Although patients with good tumour differentiation had the highest 5-year survival, this difference was not statistically significant (p=0.211). Conclusions The treatment of colon adenocarcinoma with curative resection by the end of the 20th century is accompanied with acceptable rates of overall 5-year survival. Key words Colon cancer • Five-year survival
Introduction Survival after curative resection for colonic cancer has increased in recent studies [1, 2]. Changes in the natural history of the disease, altered alimentary habits, and advances in diagnosis and treatment have been suggested as factors improving survival [2]. On the other hand, the skills and experience of the surgeon affecting survival have been analysed without consistent results [1–3]. The aim of our study was to evaluate the 5-year survival of patients with colon adenocarcinoma that underwent elective or emergency curative surgical treatment. S. Angelopoulos • I. Kanellos • E. Christophoridis • T. Tsachalis A. Kanellou • D. Betsis 4th Surgical Department Aristotle University, Thessaloniki, Greece
Patients and methods
I. Kanellos () Antheon 1 Panorama 55236, Thessaloniki, Greece E-mail:
[email protected]
Between 1993 and 1998 a total of 80 patients (41 men/39 women), with a mean age 65.6 years (SD: 12.0), underwent curative resection for colon cancer. These patients were reviewed retrospectively with intent to 5-year survival.
S. Angelopoulos et al.: Survival after curative resection Our study group does not include patients with known distant metastases and those who died from a cause other than colon cancer within 30 days of their operation or before discharge. All patients were followed up until death or for at least five years. Among the patients, 26 underwent right colectomy, 3 transverse colectomy, 13 left colectomy and 38 sigmoidectomy. In order to achieve a radical removal of the draining lymph nodes, resection of the corresponding mesenteric portion, including the vessels supplying the involved colon at their origin, was performed. All patients with cancer classified as TNM stage III underwent adjuvant chemotherapy. The overall survival was estimated with the actuarial life table analysis and it was presented with the Kaplan–Meier plot. The survival curves among different factors were compared with the Log-rank test. Analyses were conducted in SPSS 11.0 (SPSS, Inc., Chicago, IL). All reported p-values were two-tailed at a significance level of 0.05.
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than men, but this difference was not statistically significant (76% vs. 63%, p=0.245). Patients younger than 75 years old had a significantly higher 5-year survival than patients older than 75 years (75% vs. 47%, p=0.029). Tumour location did not significantly affect the 5-year
Results The overall survival was 69.5% at 5 years (Fig. 1). The comparison of survival among different factors is presented in Table 1. Five-year survival was higher in women
Fig. 1 Overall survival
Table 1 Comparison of survival among different factors Factors
n
5-year survival (%)
41 39
75.6 63.4
65 15
74.6 46.7
5 21 8 3 43
100 66.7 62.5 80.0 67.4
12 11 23 8 26
100 63.6 80.0 50.0 53.8
6 9 31 34
100 88.9 78.8 50.0
23 45 12
82.6 66.0 58.3
11 69
72.7 69.0
Sex Female Male Age
