Tumor size predicts long-term survival in colon cancer: an analysis of the National Cancer Data Base

BACKGROUND: American Joint Committee on Cancer uses tumor size for T staging of many solid tumors for its effect on prognosis. However, tumor size has not been incorporated in tumor (T), nodal status (N), metastasis (M) staging for colon cancer. Hence, the National Cancer Data Base was used to determine whether tumor size correlates with TNM staging and survival. METHODS: For the 300,386 patients, tumor size was divided into S-1 (0 to 2 cm), S-2 (>2 to 4 cm), S-3 (>4 to 6 cm), and S-4 (>6 cm). Statistical comparison was done for TNM stage, grade, and nodal status with tumor size. Kaplan-Meier survival analysis was done for each S stage. RESULTS: Of the 300,386 patients, 13% were classified as S-1, 39% S-2, 30% S-3 and 18% as S-4. Right colon was the most common site (48%). Tumor size positively correlated with grade, T stage, and nodal stage. Tumor size was inversely associated with survival. CONCLUSION: Tumor size is positively correlated with important prognostic factors and negatively impacted survival. (C) 2015 Elsevier Inc. All rights reserved.