A clinical risk score to predict 3-, 5- and 10-year survival in patients undergoing surgery for Dukes B colorectal cancer

McMillan, D.C. , McArdle, C.S. and Morrison, D.S. (2010) A clinical risk score to predict 3-, 5- and 10-year survival in patients undergoing surgery for Dukes B colorectal cancer. British Journal of Cancer, 103(7), pp. 970-974. (doi: 10.1038/sj.bjc.6605864)

Abstract

<p>Background: The prognosis of patients with Dukes stage B colorectal cancer is unpredictable and there is continuing interest in simply and reliably identifying patients at high risk of developing recurrence and dying of their disease. The aim of this study was to devise a clinical risk score to predict 3-, 5- and 10-year survival in patients undergoing surgery for Dukes stage B colorectal cancer.</p> <p>Methods: A total of 1350 patients who underwent surgery for Dukes stage B colorectal cancer between 1991 and 1994 in 11 hospitals in Scotland were included in the analysis.</p> <p>Results: On follow-up, 926 patients died of whom 479 died of their cancer. At 10 years, cancer-specific survival was 61% and overall survival was 38%. On multivariate analysis, age ≥75 (hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.15-1.82, P=0.001), emergency presentation (HR 1.59, 95% CI 1.27-1.99, P<0.001) and anastomotic leak (HR 2.17, 95% CI 1.24-3.78, P<0.01) were independently associated with cancer-specific survival in colon cancer. On multivariate analysis, only age ≥75 (HR 1.58, 95% CI 1.14-2.18, P<0.01) was associated with cancer-specific survival in rectal cancer. Age, presentation and anastomotic leak hazards could be simply added to form a clinical risk score from 0 to 2 in colon cancer. In patients with Dukes B stage colon cancer, the cancer-specific survival at 5 years for patients with a cumulative score 0 was 81%, 1 was 67% and 2 was 63%. The cancer-specific survival rate at 10 years for patients with a clinical risk score of 0 was 72%, 1 was 58% and 2 was 53%.</p> <p>Conclusion: The results of this study, in a mature cohort, introduce a new simple clinical risk score for patients undergoing surgery for Dukes B colon cancer. This provides a solid foundation for the examination of the impact of additional factors and treatment on prediction of 3-, 5- and 10-year cancer-specific survival.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Morrison, Dr David and McMillan, Professor Donald
• Authors: McMillan, D.C., McArdle, C.S., and Morrison, D.S.
• Subjects: R Medicine > RD Surgery; R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Centre for Population and Health Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
• Journal Name: British Journal of Cancer
• Publisher: Nature Publishing Group
• ISSN: 0007-0920
• ISSN (Online): 1532-1827
• Published Online: 31 August 2010
• Copyright Holders: Copyright © 2010 Cancer Research UK
• First Published: First published in British Journal of Cancer 103(7):970-974
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher