A 52-year-old man was referred to the gastroenterology department for hematochezia, tenesmus and reduction of stool diameter. A series of tests were performed and a diagnosis of adenocarcinoma of the sigma without distant metastasis was made. The patient underwent surgery and was referred to the medical oncology department for evaluation of complementary chemotherapy treatment. Which of the following is a poor prognostic factor after surgical resection and should be taken into account when planning chemotherapy treatment?
They are not asking about factors that affect oncologic prognosis and therefore imply a change in QT strategy. This question is straightforward. Option 4 is describing to us a T4 stage, either by invasion of adjacent organs or perforation. The T4s carry a much higher chance of recurrence, in fact there are ongoing studies that propose prophylactic HIPEC in T4 and second look surgery + HIPEC in perforated colon tumors.
The presence of anemia at diagnosis.
The existence of a family history of colorectal cancer.
The size of the primary lesion and histological differentiation.
Perforation or adhesion of the tumor to adjacent organs.
Option 4 is describing to us a T4 stage, either by invasion of adjacent organs or perforation. The T4s carry a much higher chance of recurrence, in fact there are ongoing studies that propose prophylactic HIPEC in T4 and second look surgery + HIPEC in perforated colon tumors.