Tumor Size Does Not Affect Survival in Stage 1 Colorectal Cancer Patients

Onur Kutlu, MD, Milad Mohammadi, MD, Steven Garcia, MD, Mark Williams, MD, Sharmila Dissanaike, MD. TTUHSC-Lubbock

Background:

The current standard for staging colorectal cancer includes tumor depth, nodal status and metastases. It is known that prognosis is highly affected by the latter two of the staging model. For many different cancers tumor size is important in determining survival and treatment. The effect of tumor size on prognosis in colorectal cancers is an area of discussion. Our aim was to evaluate the significance of tumor size on survival in patients with T1 and T2 colorectal cancers with negative nodes and no metastatic disease from the primary colorectal cancer.

Methods:

Binary logistic regression and Cox regression models were utilized to identify factors affecting survival. Surveillance epidemiology and end results database (SEER) was queried for patients diagnosed with histologically proven colorectal cancer between the years of 2004-2008. Our criteria for patient sampling included T1 and T2 tumors with a known size, negative nodal status, known CEA values, and no known metastasis. Age criteria included patients between 20 and 85. Patients were required to have minimum of 1 month follow-up. Those who were lost to follow up were excluded from the study.

Results:

11,585 patients were identified. 51.7% were male and 48.3% were female, 18.4% of the patients died at the end of 60 months. Mean tumor size was 51 (1-98) mm, CEA was elevated in 21.6% of the patients. Tumor status was as follows; Tis 3.6%, T1 32.4%, T2 64%. Factors affecting survival were CEA elevation and age over 40. Effects of tumor size, T status, sex were not found to be significant in survival (p=0.07).

Conclusion:

Many tumors have a correlation between size and survival. We studied survival in patients with colorectal cancer that had not invaded into the serosa (T1-T2) who were node negative and had no metastasis (Stage 1). Our analyses have shown that the size of the tumor did not have statistically significant impact on the survival of patients with T1-T2 lesions that had no metastasis or nodal involvement after curative surgical intervention.