Prognostic Value of the Tumor Size in Resectable Colorectal Cancer with Different Primary Locations: A Retrospective Study with the Propensity Score Matching

Abstract

Objective: To investigate the prognostic value of the tumor size in colorectal cancer (CRC) patients with different primary tumor locations.Patients and methods: We retrospectively recruited 3971 stage I-III CRC patients with curative resection. The propensity score matching technique was conducted to reduce the selection bias, producing a propensity score matched cohort of 1347 pairs of patients based on the tumor size (≤4 cm and >4 cm groups). Kaplan-Meier survival analyses and univariate and multivariate analyses were used to compare the overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) between the two groups. Subgroup analyses which were stratified by primary tumor locations and several other baseline variables were also performed for conformation.Results: In the propensity score matched cohort, the Kaplan-Meier survival curves revealed that patients with a tumor size less than 4 cm had similar OS, CSS and DFS, compared to patients with a tumor size greater than 4 cm. While in multivariate analyses, the smaller tumor size was an independent risk factor for CSS (HR, 1.275; 95% CI, 1.006-1.616; P=0.045). Subgroup analyses based on primary tumor locations further suggested that the smaller tumor size was significantly associated with worse OS (HR, 2.455; 95% CI, 1.297-4.649; P=0.006) and CSS (HR, 2.493; 95% CI, 1.202-5.174; P=0.014) in patients with right-side colon cancers (RCC).Conclusions: Our propensity matching score study indicated that the smaller tumor size was an independent risk factor for CSS in patients with stage I-III CRC, and for OS and CSS in patients with RCC.

A clinical-radiomics nomogram for the preoperative prediction of lymph node metastasis in colorectal cancer

“…Similarly, we observed a negative correlation between tumor size and LNM in this study. A recent propensity score matching study indicated that a smaller tumor size was an independent risk factor for cancer-specific survival (CSS) in patients with stage I-III CRC [26]. Hence, clinically, multivariate analysis should be used to select the best clinical treatment method to reduce the residual lesion and micrometastases, thereby reducing the possibility of tumor recurrence and improving the patient's prognosis and tumor-free survival.…”

Prognostic Factors Involved in the Epithelial–Mesenchymal Transition Process in Colorectal Cancer Have a Preponderant Role in Oxidative Stress: A Systematic Review and Meta-Analysis

“…Conversely, a more recent study including data from 300,386 patients, concludes that tumor size predicts long-term survival in colon cancer patients subjected to colectomy [ 76 ]. Similarly, a study deploying multivariate analysis on 3971 stage I–III CRC patients with curative resection has identified that a tumor size greater than 4 cm is an independent risk factor for CSS [ 77 ]. This same study indicates that the tumor side location has a differential impact on OS.…”

Treatment With Medicinal Mushroom Extract Mixture Inhibits Translation and Reprograms Metabolism in Advanced Colorectal Cancer Animal Model as Evidenced by Tandem Mass Tags Proteomics Analysis

“…On the other hand, it has been established that the volume of the primary tumor has no prognostic significance in colorectal cancer ( Wolmark et al, 1986 ; Compton et al, 2000 ). Moreover, a recent analysis of 1,357 pairs of patients showed that the smaller primary tumor size was significantly associated with worse overall survival ( Li et al, 2019 ). The most common reason for poor survival after chemotherapy treatment is impaired immune reactivity of the host and the presence of rapidly proliferating resistant cells.…”