Journal of Clinical Oncology, Vol 6, 106-118, Copyright © 1988 by American Society of Clinical Oncology
Potentially curative surgery of colon cancer: patterns of failure and survival
BD Minsky, C Mies, TA Rich, A Recht and JT Chaffey
Department of Radiation Therapy, New England Deaconess Hospital, Boston.
In an effort to determine the patterns of failure and survival of colon
cancer, a retrospective review of 294 patients who underwent potentially
curative surgery at the New England Deaconess Hospital (NEDH) was
performed. For the entire group, the 5-year crude survival rate was 68% and
the actuarial rate was 80%. Survival decreased with increasing bowel wall
penetration by tumor and the presence of lymph node metastasis. Although
survival varied with the tumor site, none of the differences was
statistically significant. Other variables, including the grade of
adenocarcinoma, size, and the type of surgery had a significant impact on
survival. Patterns of failure, expressed as the actuarial incidence of
first diagnosed failure at 5 years, were examined by stage and site. There
was a trend toward increased failure with increasing bowel wall penetration
by tumor and the presence of lymph node metastasis. Abdominal failure,
either as the only site or as a component of failure, was the most common
type of failure. When compared by site, patients with cecal carcinoma had a
significantly lower incidence of local and distant failure than patients
with disease in other selected sites. No differences in patterns of failure
were seen in patients with carcinomas in the mobile sections of the colon
compared with those who had disease arising in the nonmobile sections of
the colon. These data may be useful in identifying those patients who might
benefit most from adjuvant therapy.
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