Defining a high-risk subgroup with XXXX stages I and II for possible adjuvant therapy.

@entity1 @entity694 @entity5
AIM: Adjuvant therapy is not routinely recommended in UICC stages I and II @entity694 , but may be considered for high-risk @entity1 . Our aim is to identify clinicopathologic characteristics in @entity694 stages I and II, which are associated with an increased risk of @entity5 recurrence and @entity5 . METHODS: We analysed our prospectively documented clinical database of 775 @entity1 with @entity694 stages I and II, which underwent curative resection between 1982 and 2006. No adjuvant chemotherapy was applied. The median follow-up time was 80 months. RESULTS: For the entire study group, 5- and 10-year @entity5 -specific survival probabilities were 94.8+/-0.9% and 91.0+/-1.4%, respectively. Multivariate analysis identified three @entity5 characteristics as independent prognostic factors: lymphatic vessel invasion (p=0.034), poor @entity5 grading (G3/G4) (p=0.020) and extended @entity5 length (6 cm) (p=0.042). Five-year (10-year) @entity5 -specific survival for @entity1 without any of the poor prognostic @entity5 characteristics (ppTCs) was 96.0% (94.7%). There was a significantly increased risk for @entity5 with increasing numbers of ppTCs (p<0.001). While @entity1 with only one ppTC had a 5-year (10-year) @entity5 -specific survival of 94.8% (88.9%), it decreased to 88.9% (78.4%) for @entity1 with two ppTCs (hazard ratio (HR) 3.69, 95% confidence interval (CI) 1.67-8.13) and to 87.5% (72.9%) for @entity1 with all three ppTCs (HR 6.56, 95% CI 1.50-26.62). CONCLUSION: @entity1 with stage I or II @entity694 have a favourable prognosis after radical resection. The presence of two or three poor prognostic @entity5 characteristics identifies a small @entity1 subgroup (12%) with an increased risk of @entity5 that may be considered for adjuvant chemotherapy.
