Stage II colon cancer: epidemiological, clinical characteristics, and comparison of survival according to prognostic factors

Abstract

Author(s): Soukaina El Anssari*, Zineb Benbrahim, Youssef Elhaitmy, Fatima Zahrae Bartal, Lamiae Amaadour, Karima Oualla, Samia Arifi and Mellas Nawfel

Colorectal Cancer (CRC) is a major public health problem in Morocco and ranks second among digestive cancer after gastric cancer. The indication for adjuvant chemotherapy for stage II colon cancer remains controversial but should be considered in patients with high-risk characteristics. The objective of our study is to report clinical characteristics, poor prognostic factors and compare the Overall Survival (OS) and Recurrence Free Survival (RFS) according to the number of poor prognostic factors. This is a retrospective study which included 191 patients with colon cancer treated at the medical oncology department of Fez over a period from June 2010 to June 2023. Kaplan Meier method was used to evaluate median survival. 54 patients were diagnosed between the year 2010/2014 vs. 65 patients between 2015/2018 and 72 new patients between 2019/2023. The average age at the time of diagnosis was 58 years. The main clinical symptoms were occlusion, abdominal pain and transit disorders objectified in 33%, 28% and 26% of patients respectively. 53 patients (28%) had a stable Microsatellite Status (MSS), while only 16 patients (8%) were MSI. The most common poor prognostic factors were occlusion, pT4 status, vascular emboli and perforation found in 33%, 29%, 23.5% and 23% respectively. 41 patients (21.6%) had a single poor prognostic factor vs. 59 patients (31.1%) had 2 prognostic factors. The presence of 3 or more risk factors was reported in 68 patients (35.8%). Median Overall Survival (OS) and Recurrence Free Survival (RFS) was 88.5 months and 36.3 months respectively. We found significant variations in survival related to poor prognostic factors. Our study showed a decrease in the median OS and RFS with the increase of poor prognostic factors from 2 risk factors or more.

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