EP1063 - Determinants of Long-Term Overall Survival in Surgically Treated Colon Cancer

Monday, May 11, 2026

3:51 PM - 3:56 PM ET

ePoster Presenter(s)

Maanasa Javangula, BA

Medical Student
Medical College of Georgia
Medical College of Georgia
Alpharetta, GA, United States

Disclosure information not submitted.

Author(s)

DM

Daniel Moncada, MS

Medical Student
Medical College of Georgia
Auguta, Georgia, United States

Disclosure information not submitted.
LM

Leah Middleton, BS, MS

Medical Student
Medical College of Georgia at Augusta University
North Augusta, South Carolina, United States

Disclosure information not submitted.
DY

Danny Yakoub, MD, PHD

Chief of Division of Surgical Oncology
Medical College of Georgia at Augusta University - Georgia Cancer Center
Augusta, Georgia, United States

Disclosure information not submitted.
Susan Gearhart, MD

Adjunct Professor of Surgery
Johns Hopkins Medicine
Johns Hopkins Medicine
Baltimore, MD, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

Swadha Guru, MD

Assistant Professor
Medical College of Georgia
Henry Ford Hospital
Augusta, Georgia, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Susan Gearhart, MD: This individual has no financial relationships with ineligible companies.

Purpose/Background: Colorectal cancer is the 4th most common cancer diagnosis. With access to newer screening modalities and advances in cancer treatment, there has been notable improvements in early detection and survival. We aim to determine stage specific overall survival in surgically treated colon cancer and examine the impact patient, disease, and treatment-related factors may have on overall survival.

Methods/Interventions: Patients with surgically treated colon cancer were identified from the National Cancer Database (2004-2019). AJCC stage information was standardized into stages I-IV. Survival was grouped as 0-2, 2-5, or >5 years from diagnosis to last contact or death, without censoring. Ordinal logistic regression estimated adjusted odds ratios (aORs), reflecting the likelihood of belonging to a higher survival category after accounting for demographic, socioeconomic, tumor, and oncological treatment characteristics.

Results/Outcomes: Out of 292,327 patients, 34.8% had stage I, 24.6% II, 16.5% III, and 24.1% IV of disease. When examining the likelihood of surviving >5 years, across stages I–IV, older age consistently correlated with lower odds of long-term survival (aOR 0.97–0.98, p< 0.001).

Lack of insurance or Medicaid coverage was associated with a lower likelihood of >5-year survival across all stages. The non-Hispanic Black population demonstrated lower odds of survival in Stage I (aOR 0.84, 95% CI 0.71–1.00), III (aOR 0.88, 95% CI 0.78–0.99), and IV (aOR 0.89, 95% CI 0.82–0.98). Higher comorbidity burden adversely affected survival in Stage I (aOR 0.85, 95% CI 0.79–0.91), II (aOR 0.92, 95% CI 0.85–0.98), and III (aOR 0.87, 95% CI 0.82–0.92).

Well or moderately differentiated tumors were associated with a greater likelihood of >5 year survival in Stage II (aOR 1.55–1.67, 95% CI 1.14–2.37), III (aOR 1.60–1.75, 95% CI 1.32–1.94), and IV (aOR 1.88–2.35, 95% CI 1.63–2.17). Lack of lymphovascular invasion conferred higher odds of survival in Stage II (aOR 1.38, 95% CI 1.25–1.53) and IV (aOR 1.64, 95% CI 1.54–1.74).

Achieving negative surgical margins was among the strongest predictors of long-term survival across all stages (Stage I aOR 1.88, 95% CI 1.45–2.44; II aOR 1.97, 95% CI 1.68–2.31; III aOR 4.47, 95% CI 2.85–7.02; IV aOR 1.72, 95% CI 1.42–2.08). Treatment at academic or research centers was associated with improved survival in Stage I (aOR 1.22, 95% CI 1.04–1.43), III (aOR 1.16, 95% CI 1.05–1.29), and IV (aOR 1.23, 95% CI 1.13–1.35).

Conclusion/Discussion: Despite improvements in detection and treatment of colon cancer, long term survival among patients treated with surgery for colon cancer remains significantly impacted by demographic, socioeconomic, and treatment related factors suggesting that modifiable disparities exist and should be considered as targets for improving overall survival.