Disease-Free Probability Following Colon Cancer Surgery

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Our third-generation disease-free probability clinical calculator is a tool designed to predict the likelihood of remaining free of colon cancer at three years and five years after undergoing a complete resection (surgical removal of all cancerous tissue). It is appropriate for patients whose colon cancer had shown no evidence of distant metastasis, or spread to other organs beyond the colon, before surgery or at the time of surgery.

Results produced by this tool are based on data from patients treated at MSK, a large research institution with surgeons who perform a high volume of colon cancer procedures. All results must be understood in the context of each patient’s specific treatment plan. Patients and caregivers using this tool should discuss the result with the patient’s physician.

To gather the information required to use this clinical calculator, use our worksheet.

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All fields are required unless noted optional
Was cancer present in the lymphatic or blood vessels, or in or around the nerves?
What is lymphovascular invasion, large venous invasion, and perineural invasion?

Lymphovascular invasion means that cancer cells were found in the small vessels of the colon (arteries, veins, and/or lymphatics).

Large venous invasion means that cancer cells were found in the large vessels of the colon.

Perineural invasion means that cancer cells were found in or around the nerves near the colon or rectum.

Does your colon cancer show microsatellite instability?
Note: There are two types of tests used to look for microsatellite instability (MSI) in colon cancer tumor samples. MSI testing looks for changes in the DNA sequence between normal and tumor tissues to identify if there is high amount of instability. Another test, called immunohistochemical staining (IHC), looks for the absence of certain proteins, called mismatch repair proteins (MLH1, MSH2, MSH6 and PMS2), that are involved in correcting mistakes made when DNA is copied in a cell; the absence of one of the mismatch repair proteins indirectly reflects the presence of MSI.
What is microsatellite instability?
Microsatellite instability (MSI) refers to a genetic change that occurs in tumors in which the number of repeated DNA bases in a microsatellite (a short, repeated sequence of DNA) is different from what it was when the microsatellite was inherited. MSI may be caused by mistakes that don’t get corrected when DNA is copied in a cell. It is found most often in colorectal cancer, gastric cancer, and endometrial cancer, but it may also be found in many other types of cancer. Knowing whether a cancer has MSI helps understand the risk of recurrence and may help plan the best treatment.
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What are lymph nodes?
Lymph nodes are rounded masses of tissue that act as filters for a fluid called lymph. Lymph nodes are located along lymphatic vessels, and they store lymphocytes (white blood cells).
Did you receive chemotherapy after your surgery?
Were tumor-infiltrating lymphocytes present in your colon tumor?
What is a tumor-infiltrating lymphocyte?
A tumor-infiltrating lymphocyte (TIL) is a type of immune cell that has moved from the blood into a tumor. TILs can recognize and kill cancer cells.
Note: This prediction tool is only applicable for T stages T1 to T4. Indicating the substage by letter (e.g., a or b) is not required.
More on T Staging
The T stages are part of the TNM Staging System, which uses TNM classifications to describe the extent of cancer in a patient's body. T describes how deep the tumor has invaded into the colon wall; N describes whether regional lymph nodes are involved and, if so, how extensively; and M describes whether distant metastasis (spread of cancer from one body part to another) is present. The system is maintained by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC) and is updated periodically.
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