Research Papers:

The survival and clinicopathological differences between patients with stage IIIA and stage II rectal cancer: An analysis of 12,036 patients in the SEER database

Ben Huang, Shaobo Mo, Liang Zhu, Tianhong Xu and Guoxiang Cai _

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Oncotarget. 2016; 7:79787-79796. https://doi.org/10.18632/oncotarget.12970

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Ben Huang1,*, Shaobo Mo1,*, Liang Zhu1, Tianhong Xu1, Guoxiang Cai1

1Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 20032, People’s Republic of China

*These authors have contributed equally to this work

Correspondence to:

Guoxiang Cai, email: gxcfuscc@163.com

Keywords: rectal cancer, stage IIIA, stage II, survival

Received: August 02, 2016    Accepted: October 17, 2016    Published: October 28, 2016


Background: Stage IIIA rectal cancer has distinctive oncological features, including limited depth of intestinal wall invasion and early regional lymph node metastasis. We aim to compare survival outcomes and clinicopathological features for stage IIIA rectal cancer with those for stage II rectal cancer.

Method: We analyzed patients with stage II or stage IIIA rectal cancer treated with surgery without receiving preoperative radiotherapy based on data from the US Surveillance, Epidemiology, and End Results (SEER) database between 1988 and 2003. Survival curves were plotted using the Kaplan-Meier method. Multivariate Cox proportional analyses were utilized to analyze independent prognostic factors for cancer-specific survival (CSS).

Results: We included 12,036 rectal cancer patients (10,132 stage II and 1,904 stage IIIA) from the SEER database. Patients with stage IIIA rectal cancer had smaller tumor size than patients with stage II rectal cancer. A multivariate analysis suggested that compared with patients with stage IIIA rectal cancer, patients with stage II disease were more likely to have more unfavorable CSS (HR 1.195, 95% CI 1.079-1.324, p=0.001). When stage II rectal cancer was further analyzed as stage IIA, IIB and IIC rectal cancer, the multivariate analysis indicated that compared with patients with stage IIIA rectal cancer, patients with stage IIA rectal cancer (HR 1.113, 95% CI 1.003-1.235, p=0.044), stage IIB rectal cancer (HR 1.493, 95% CI 1.267-1.758, p<0.001) and stage IIC rectal cancer (HR 2.712, 95% CI 2.319-3.171, p<0.001) were also more likely to exhibit more unfavorable CSS.

Conclusion: Patients with stage IIIA rectal cancer had more favorable survival outcomes and smaller tumor size compared with patients with stage II rectal cancer.

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