Long-Term Follow-Up of Patients Undergoing Resection of TNM Stage I Colorectal Cancer: An Analysis of Tumour and Host Determinants of Outcome
| Autor: | David Mansouri, Arfon Powell, James H. Park, Paul G. Horgan, Donald C. McMillan |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Time Factors Colorectal cancer Disease Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Aged Neoplasm Staging Univariate analysis business.industry Age Factors Vascular surgery medicine.disease Prognosis Systemic Inflammatory Response Syndrome Surgery Cardiac surgery Survival Rate C-Reactive Protein Treatment Outcome Cardiothoracic surgery 030220 oncology & carcinogenesis Female Emergencies business Colorectal Neoplasms Abdominal surgery Follow-Up Studies |
| Zdroj: | World journal of surgery. 40(6) |
| ISSN: | 1432-2323 |
| Popis: | Background Screening for colorectal cancer improves cancer-specific survival (CSS) through the detection of early-stage disease; however, its impact on overall survival (OS) is unclear. The present study examined tumour and host determinants of outcome in TNM Stage I disease. Methods All patients with pathologically confirmed TNM Stage I disease across 4 hospitals in the North of Glasgow between 2000 and 2008 were included. The preoperative modified Glasgow Prognostic Score (mGPS) was used as a marker of the host systemic inflammatory response (SIR). Results There were 191 patients identified, 105 (55 %) were males, 91 (48 %) were over the age of 75 years and 7 (4 %) patients underwent an emergency operation. In those with a preoperative CRP result (n = 150), 35 (24 %) patients had evidence of an elevated mGPS. Median follow-up of survivors was 116 months (minimum 72 months) during which 88 (46 %) patients died; 7 (8 %) had postoperative deaths, 15 (17 %) had cancer-related deaths and 66 (75 %) had non-cancer-related deaths. 5-year CSS was 95 % and OS was 76 %. On univariate analysis, advancing age (p < 0.001), emergency presentation (p = 0.008), and an elevated mGPS (p = 0.012) were associated with reduced OS. On multivariate analysis, only age (HR = 3.611, 95 % CI 2.049–6.365, p < 0.001) and the presence of an elevated mGPS (HR = 2.173, 95 % CI 1.204–3.921, p = 0.010) retained significance. Conclusions In patients undergoing resection for TNM Stage I colorectal cancer, an elevated mGPS was an objective independent marker of poorer OS. These patients may benefit from a targeted intervention. |
| Databáze: | OpenAIRE |
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