Spanish 
Chinese 
Russian 
German 
French 
Japanese 
Portuguese 
Hindi Research Article
Assessment of the Importance of Non-Stage Related Factors in the Prognosis of Resected Colorectal Cancer
Jamish Gandhi1*, Fraser Welsh1 and Keating JP2
1Surgical Registrar, Wellington Hospital, Wellington Hospital, New Zealand
2Colon and Rectal Surgeon, Wellington Hospital, New Zealand
- *Corresponding Author:
- Jamish Gandhi
Department of General Surgery, Wellington Hospital
PO Box 7343, Wellington Southm, New Zealand
Tel: 0064 212667892
E-mail: j.gandhi@xtra.co.nz
Received date: November 08, 2012; Accepted date: December 12, 2014; Published date: December 15, 2014
Citation: Gandhi J, Welsh F, Keating JP (2014) Assessment of the Importance of Non-Stage Related Factors in the Prognosis of Resected Colorectal Cancer. J Gastrointest Dig Syst 4:244. doi:10.4172/2161-069X.1000244
Copyright: © 2014 Gandhi J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Objective: To assess the importance of clinical and histopathological features in the risk stratification of resected colorectal cancer and their utility as indicators of the need for adjuvant therapy.
Methods: Prospectively collected data was analysed from 524 consecutive cases of colon and rectal cancer resected by a single surgical team with a median follow up of 49 months. Multivariate analysis was used to determine clinical and pathological features that independently predicted cancer related death and their relative importance.
Results: Pathological features associated with an increased risk of cancer related death were the presence of metastatic disease, penetration of the bowel wall, lymph node status, perineural invasion and vascular invasion. Emergent surgery was the only clinical feature to predict cancer related death. Adjuvant chemotherapy significantly improved the survival of colorectal cancer patients whose tumours demonstrated either vascular or perineural invasion.
Conclusions: Vascular and perineural invasion and emergent surgery are independent and significant predictors of death from colorectal cancer. Adjuvant chemotherapy improved the survival of patients whose tumours demonstrated vascular or perineural invasion. The components of TNM stage alone do not provide enough information on which to make decisions on the utility of adjuvant chemotherapy.
