Tumor size as a prognostic factor in patients with stage IIa colon cancer

Francesco Santullo, Alberto Biondi, Ferdinando C M Cananzi, Valeria Fico, Flavio Tirelli, Riccardo Ricci, Gianluca Rizzo, Claudio Coco, Claudio Mattana, Domenico D'Ugo, Roberto Persiani

Research output: Contribution to journalArticlepeer-review


BACKGROUND: The aim of this study was to identify stage II colon cancer patients with a high risk of recurrence.

METHODS: All patients who underwent surgery for stage II colon cancer (CC) were retrospectively enrolled and sub-grouped according to TNM staging (IIa-b-c) and stage IIa in high (IIaHR) and low risk (IIaLR) according to pathologic features. The primary outcomes measured were the 5-year overall survival (OS) and disease-free survival (DFS).

RESULTS: A total of 214 patients were reviewed. Only a maximum tumor diameter<4 cm in the IIaLR group was associated with a higher recurrence rate than a large tumor size (5-year DFS 71.7%vs.87.6%, p = 0.028). The DFS in the large IIaLR CC group was better than that in the IIaHR and IIb-c groups (5-year DFS: 92.7%vs.79.3%, p = 0.023). In contrast, the recurrence rate in the small IIaLR CC group was similar to that in the IIaHR, IIb-c stage CC group.

CONCLUSIONS: In stage IIa CC evaluation of the tumor size as a prognostic factor may help identify patients who could benefit from additional postoperative therapy.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalAmerican Journal of Surgery
Issue number1
Publication statusPublished - Jan 2018


  • Adenocarcinoma/diagnosis
  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy
  • Colonic Neoplasms/diagnosis
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local/epidemiology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Tumor Burden


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