Merkel et al identified risk factors in patients with Stage II colon carcinoma. These can help to identify high risk patients who may benefit from adjuvant chemotherapy. The authors are from the University of Erlangen in Germany.
Stage II colon carcinomas are defined as T3N0M0 or T4N0M0.
NOTE: This does not include rectal carcinomas.
Risk factors:
(1) tumor in the left colon (descending and sigmoid)
(2) pathologic stage T3 tumors extending > 15 mm beyond the outer border of the muscularis propria
(3) pathologic stage T4 tumor
(4) tumors with an emergency presentation (perforation, etc., require urgent surgery within 48 hours of admission)
Patterns of Risk Factors
Risk Group
Distant Metastasis Rate
Approximate 5 Year Survival Rate
no risk factors
low
8%
96%
1 risk factor other than emergency surgery
low
9 - 13%
91 - 96%
2 risk factors other than emergency surgery
high
24%
84%
emergency presentation
high
38%
70%
from Table 6, page 1439
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