Population-based study of prognostic factors in XXXX .

@entity1 @entity6402 @entity5 @entity14
BACKGROUND: Adjuvant chemotherapy in stage II @entity14 may be considered for @entity1 whose @entity5 have poor prognostic features. The aim of this study was to evaluate the prognostic significance of commonly reported clinical and pathological features of @entity5 . METHODS: A population-based observational study of all @entity1 with @entity5 diagnosed in the state of Western Australia from 1993 to 2003 was performed. A total of 1306 @entity1 treated by surgery alone were identified, with a median follow-up of 59 (range 0-145) months. RESULTS: Multivariable analysis revealed that the only independent prognostic factors for disease-specific survival were stage T4 (hazard ratio (HR) 1.75 (95 per cent confidence interval (c.i.) 1.32 to 2.32); P < 0.001) and vascular invasion (HR 1.63 (95 per cent c.i. 1.15 to 2.30); P < 0.001). In younger @entity1 (aged 75 years or less), who are more likely to be considered for chemotherapy, these two features showed independent prognostic significance but with higher HR values (1.96 for stage @entity6402 .73 for vascular invasion). Stage T4 and/or the presence of vascular invasion identified a 'poor' prognostic group, comprising 26.6 per cent of younger @entity1 and with a 5-year survival rate of 71.2 per cent. The remaining 'good' prognostic group had a survival rate of 84.3 per cent at 5 years' follow-up. CONCLUSION: This study highlights the importance of accurate pathological assessment of @entity5 stage and vascular invasion for the prognostic stratification of @entity1 with @entity5 . The results provide clarification of guidelines for the management of stage II disease in relation to recommendations for chemotherapy.
