Recurrence-Free Survival Outcomes Based on Novel Classification Combining Lymphovascular Invasion, Perineural Invasion, and T4 Status in Stage II–III Colon Cancer

Figures & data

Table 1 Patient Characteristics (n = 1247)

	No (%)
Age (years)	67.3 (26–89)
Gender
Male	703 (56.4)
Female	544 (43.6)
CEA	13.0 (42.0)
ASA
I	122 (9.8)
II	715 (57.3)
III	377 (30.2)
IV/V	33 (2.7)
Comorbidities	807 (64.7)
Location of tumor
Right colon	586 (46.9)
Left colon	661 (53.0)
TNM stage
II	612 (49.0)
III	635 (50.9)
Histologic grade
Well	280 (22.5)
Moderate	878 (70.4)
Poor/undifferentiated	89 (7.1)
Obstruction	306 (24.5)
T4	192 (15.4)
LVI	551 (44.1)
PNI	319 (25.0)
Adjuvant chemotherapy	771 (61.9)
5FU-LV	172 (22.3)
FOLFOX	463 (60.3)
FORFIRI	41 (5.3)
Capecitabine	76 (8.2)
Others	19 (1.5)

Note: Data are presented as the number of patients (%) or median (range) unless otherwise stated.

Abbreviations: No, number; CEA, Carcinoembryonic Antigen; ASA, American Society of Anesthesiologists; LVI, Lymphovascular invasion; PNI, Perineural invasion.

Table 2 Comparison of Clinicopathologic Features According to the Risk Grouping

	No Risk (n = 470)	Low Risk (n = 485)	High Risk (n = 292)	P
Age ≧ 70 (years)	222 (47.2)	220 (45.4)	114 (39.0)	0.034
Male	192 (40.9)	209 (43.1)	143 (49.0)	0.033
ASA ≧ 3	192 (36.2)	168 (34.1)	50 (22.3)	0.003
Comorbidities ≧ 3	62 (13.2)	51 (10.5)	21 (7.2)	0.009
TNM stage
II	366 (68.9)	193 (39.2)	53 (23.7)	< 0.001
III	165 (31.1)	299 (60.8)	171 (76.3)
T stage
1	15 (2.8)	11 (2.3)	1 (0.3)	< 0.001
2	13 (2.4)	24 (4.9)	5 (1.7)
3	442 (83.2)	389 (80.2)	155 (53.1)
4	0 (0)	61 (12.6)	131 (44.9)
N stage
0	322 (68.5)	219 (45.2)	66 (22.6)	< 0.001
1	126 (26.8)	177 (36.5)	108 (37.0)
2/3	22 (4.7)	88 (18.1)	118 (40.4)
Histologic grade
Well/Moderate	442 (94.2)	453 (93.4)	263 (90.1)	0.037
Poor/Undifferentiated	27 (5.8)	32 (6.6)	29 (9.9)
No of harvested LN ≧ 12	442 (94.0)	461 (95.4)	286 (97.9)	0.013
Adjuvant chemotherapy	229 (48.7)	335 (69.2)	207 (71.1)	< 0.001

Note: Data are presented as the number of patients (%).

Abbreviations: ASA, American Society of Anesthesiologists; No, number; LN, Lymph node; LVI, Lymphovascular invasion; PNI, Perineural invasion.

Figure 1 Comparison of 5-year recurrence-free survival according to the risk grouping and TNM stage in patients with stage II–III (A) no-risk group, 78.5%; low-risk group, 65.5%; high-risk group, 58.7%, P < 0.001), in patients with stage II (B) no-risk group, 82.54%; low-risk group, 76.2%; high-risk group, 55.5%; P < 0.001), in patients with stage III (C) no-risk group, 76.0%; low-risk group, 59.9%; high-risk group, 57.0%; P < 0.001).

Table 3 Univariate and Multivariate Analysis of Recurrence-Free Survival

Variable	Univariate Analysis		Multivariate Analysis
	OR (95% CI)	P	OR (95% CI)	P
Age ≧ 70 (years)	1.675 (1.336–2.101)	<0.001	1.592 (1.237–2.049)	< 0.001
Male	1.179 (0.940–1.478)	0.155	1.025 (0.811–1.296)	0.833
ASA ≧ 3	1.751 (1.393–2.203)	<0.001	1.627 (1.264–2.095)	< 0.001
Comorbidities ≧ 3	1.212 (0.848–1.731)	0.292	1.034 (0.710–1.505)	0.863
Poor/Undifferentiated	1.390 (0.942–2.051)	0.097	1.135 (0.762–1.693)	0.533
T4	2.061 (1.579–2.689)	<0.001	1.770 (1.339–2.340)	< 0.001
LVI	1.648 (1.308–2.076)	<0.001	1.123 (1.013–1.578)	0.043
PNI	1.664 (1.309–2.114)	<0.001	1.363 (1.055–1.760)	0.018
Obstruction	1.501 (1.173–1.922)	0.001	1.312 (1.019–1.689)	0.035
LN metastasis	1.879 (1.484–2.381)	<0.001	1.683 (1.304–2.171)	< 0.001

Abbreviations: OR, Odd Ratio; CI, Confidence interval; ASA, American Society of Anesthesiologists; LVI, Lymphovascular invasion; PNI, Perineural invasion; LN, lymph node.

Figure 2 Comparison of 5-year recurrence-free survival in patients with stage II according to the presence of risk factors and chemotherapy (A) stage II: 75% (chemotherapy (-)) vs 79.4% (chemotherapy (+)); P = 0.338), (B) stage II with no risk factor: 80.5% (chemotherapy (-)) vs 86.3% (chemotherapy (+)); P = 0.232), (C) stage II with one or more risk factors; 59.5% chemotherapy (-) vs 75.2% (chemotherapy (+)); P < 0.001).

Table 4 Univariate and Multivariate Analysis of Predicting Factor for the High Risk Group

Variable	Univariate Analysis		Multivariate Analysis
	OR (95% CI)	P	OR (95% CI)	P
Age ≧ 70 (years)	0.607 (0.355–1.037)	0.065	0.671 (0.384–1.171)	0.160
Male	0.968 (0.580–1.615)	0.900	0.956 (0.559–1.634)	0.868
Poor/Undifferentiated	2.329 (1.109–4.890)	0.041	2.197 (1.022–4.726)	0.044
Obstruction	2.269 (1.350–3.813)	0.003	2.182 (1.287–3.699)	0.004
Presence of LN (+)	3.879 (2.085–7.216)	<0.001	3.729 (1.995–6.970)	< 0.001

Abbreviations: OR, Odd Ratio; CI, Confidence interval; LN, lymph node.