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Published in: International Journal of Colorectal Disease 11/2008

01-11-2008 | Original Article

Local recurrence after curative resection in patients with colon and rectal cancers

Authors: H. R. Yun, L. J. Lee, J. H. Park, Y. K. Cho, Y. B. Cho, W. Y. Lee, H. C. Kim, H. K. Chun, S. H. Yun

Published in: International Journal of Colorectal Disease | Issue 11/2008

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Abstract

Background and aims

There are a range of rates and a number of prognostic factors associated with the local recurrence of colorectal cancer after curative resection. The aim of this study was to identify the potential prognostic factors of local recurrence in patients with colon and rectal cancers.

Materials and methods

A retrospective review of 1,838 patients who underwent curative resection of non-metastatic colorectal cancer was conducted. The patients were treated between 1994 and 2004, and had a minimum follow-up of 3 years.

Results

There were 994 patients with colon cancer and 844 patients with rectal cancer. The median duration of follow-up was 60.9 ± 24.5 months. With respect to colon cancer, the local recurrence rate was 6.1% (61 patients). With respect to rectal cancer, 95 patients had a local recurrence (11.3%), the rate of which was statistically greater than the local recurrence rate for colon cancer (p < 0.001). The overall recurrence rate was 16.4% (301 patients), and the local recurrence rate, with or without systemic metastases, was 8.5% (156 patients). Local recurrences occurred within 2 and 3 years in 59.9% and 82.4% of the patients, respectively. In patients with colon and rectal cancer, the pathologic T stage (p = 0.044 and p = 0.034, respectively), pathologic N stage (p = 0.001 and p < 0.001, respectively), and lymphovascular invasion (p = 0.013 and p = 0.004, respectively) were adverse risk factors for local recurrence. The level of the anastomosis from the anal verge was an additional prognostic factor (p = 0.007) in patients with rectal cancer.

Conclusion

Compulsive follow-up care of patients with colon and rectal cancers is needed for 3 years after curative resection, especially in patients who have adverse risk factors for local recurrence.
Literature
1.
go back to reference Harris GJ, Church JM, Senagore AJ et al (2002) Factors affecting local recurrence of colonic adenocarcinoma. Dis Colon Rectum 45(8):1029–1034PubMedCrossRef Harris GJ, Church JM, Senagore AJ et al (2002) Factors affecting local recurrence of colonic adenocarcinoma. Dis Colon Rectum 45(8):1029–1034PubMedCrossRef
2.
go back to reference Obrand DI, Gordon PH (1997) Incidence and patterns of recurrence following curative resection for colorectal carcinoma. Dis Colon Rectum 40(1):15–24PubMedCrossRef Obrand DI, Gordon PH (1997) Incidence and patterns of recurrence following curative resection for colorectal carcinoma. Dis Colon Rectum 40(1):15–24PubMedCrossRef
3.
go back to reference Malcolm AW, Perencevich NP, Olson RM et al (1981) Analysis of recurrence patterns following curative resection for carcinoma of the colon and rectum. Surg Gynecol Obstet 152(2):131–136PubMed Malcolm AW, Perencevich NP, Olson RM et al (1981) Analysis of recurrence patterns following curative resection for carcinoma of the colon and rectum. Surg Gynecol Obstet 152(2):131–136PubMed
4.
go back to reference Adloff M, Arnaud JP, Schloegel M, Thibaud D (1985) Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum. Dis Colon Rectum 28(6):413–415PubMedCrossRef Adloff M, Arnaud JP, Schloegel M, Thibaud D (1985) Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum. Dis Colon Rectum 28(6):413–415PubMedCrossRef
5.
go back to reference Bruinvels DJ, Stiggelbout AM, Kievit J et al (1994) Follow-up of patients with colorectal cancer. A meta-analysis. Ann Surg 219(2):174–182PubMedCrossRef Bruinvels DJ, Stiggelbout AM, Kievit J et al (1994) Follow-up of patients with colorectal cancer. A meta-analysis. Ann Surg 219(2):174–182PubMedCrossRef
6.
go back to reference Cass AW, Million RR, Pfaff WW (1976) Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum. Cancer 37(6):2861–2865PubMedCrossRef Cass AW, Million RR, Pfaff WW (1976) Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum. Cancer 37(6):2861–2865PubMedCrossRef
7.
go back to reference McCall JL, Cox MR, Wattchow DA (1995) Analysis of local recurrence rates after surgery alone for rectal cancer. Int J Colorectal Dis 10(3):126–132PubMedCrossRef McCall JL, Cox MR, Wattchow DA (1995) Analysis of local recurrence rates after surgery alone for rectal cancer. Int J Colorectal Dis 10(3):126–132PubMedCrossRef
8.
go back to reference Pescatori M, Mattana C, Maria G et al (1987) Outcome of colorectal cancer. Br J Surg 74(5):370–372PubMedCrossRef Pescatori M, Mattana C, Maria G et al (1987) Outcome of colorectal cancer. Br J Surg 74(5):370–372PubMedCrossRef
9.
go back to reference Polglase AL, McMurrick PJ, Tremayne AB, Bhathal PS (2001) Local recurrence after curative anterior resection with principally blunt dissection for carcinoma of the rectum and rectosigmoid. Dis Colon Rectum 44(7):947–954PubMedCrossRef Polglase AL, McMurrick PJ, Tremayne AB, Bhathal PS (2001) Local recurrence after curative anterior resection with principally blunt dissection for carcinoma of the rectum and rectosigmoid. Dis Colon Rectum 44(7):947–954PubMedCrossRef
10.
go back to reference Pietra N, Sarli L, Costi R et al (1998) Role of follow-up in management of local recurrences of colorectal cancer: a prospective, randomized study. Dis Colon Rectum 41(9):1127–1133PubMedCrossRef Pietra N, Sarli L, Costi R et al (1998) Role of follow-up in management of local recurrences of colorectal cancer: a prospective, randomized study. Dis Colon Rectum 41(9):1127–1133PubMedCrossRef
11.
go back to reference Kraemer M, Wiratkapun S, Seow-Choen F et al (2001) Stratifying risk factors for follow-up: a comparison of recurrent and nonrecurrent colorectal cancer. Dis Colon Rectum 44(6):815–821PubMedCrossRef Kraemer M, Wiratkapun S, Seow-Choen F et al (2001) Stratifying risk factors for follow-up: a comparison of recurrent and nonrecurrent colorectal cancer. Dis Colon Rectum 44(6):815–821PubMedCrossRef
12.
go back to reference Read TE, Mutch MG, Chang BW et al (2002) Locoregional recurrence and survival after curative resection of adenocarcinoma of the colon. J Am Coll Surg 195(1):33–40PubMedCrossRef Read TE, Mutch MG, Chang BW et al (2002) Locoregional recurrence and survival after curative resection of adenocarcinoma of the colon. J Am Coll Surg 195(1):33–40PubMedCrossRef
13.
go back to reference Sjovall A, Holm T, Singnomklao T et al (2007) Colon cancer management and outcome in relation to individual hospitals in a defined population. Br J Surg 94:491–499PubMedCrossRef Sjovall A, Holm T, Singnomklao T et al (2007) Colon cancer management and outcome in relation to individual hospitals in a defined population. Br J Surg 94:491–499PubMedCrossRef
14.
go back to reference Das P, Skibber JM, Rodriguez-Bigas MA et al (2006) Clinical and pathologic predictors of locoregional recurrence, distant metastasis, and overall survival in patients treated with chemoradiation and mesorectal excision for rectal cancer. Am J Clin Oncol 29(3):219–224PubMedCrossRef Das P, Skibber JM, Rodriguez-Bigas MA et al (2006) Clinical and pathologic predictors of locoregional recurrence, distant metastasis, and overall survival in patients treated with chemoradiation and mesorectal excision for rectal cancer. Am J Clin Oncol 29(3):219–224PubMedCrossRef
15.
go back to reference Dorrance HR, Docherty GM, O'Dwyer PJ (2000) Effect of surgeon specialty interest on patient outcome after potentially curative colorectal cancer surgery. Dis Colon Rectum 43(4):492–498PubMedCrossRef Dorrance HR, Docherty GM, O'Dwyer PJ (2000) Effect of surgeon specialty interest on patient outcome after potentially curative colorectal cancer surgery. Dis Colon Rectum 43(4):492–498PubMedCrossRef
16.
go back to reference Fujita S, Shimoda T, Yoshimura K et al (2003) Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection. J Surg Oncol 84(3):127–131PubMedCrossRef Fujita S, Shimoda T, Yoshimura K et al (2003) Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection. J Surg Oncol 84(3):127–131PubMedCrossRef
17.
go back to reference Harrison LE, Guillem JG, Paty P, Cohen AM (1997) Preoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients: a multivariate analysis of 572 patients. J Am Coll Surg 185(1):55–59PubMed Harrison LE, Guillem JG, Paty P, Cohen AM (1997) Preoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients: a multivariate analysis of 572 patients. J Am Coll Surg 185(1):55–59PubMed
18.
go back to reference Hohenberger P, Schlag P, Kretzschmar U, Herfarth C (1991) Regional mesenteric recurrence of colorectal cancer after anterior resection or left hemicolectomy: inadequate primary resection demonstrated by angiography of the remaining arterial supply. Int J Colorectal Dis 6(1):17–23PubMedCrossRef Hohenberger P, Schlag P, Kretzschmar U, Herfarth C (1991) Regional mesenteric recurrence of colorectal cancer after anterior resection or left hemicolectomy: inadequate primary resection demonstrated by angiography of the remaining arterial supply. Int J Colorectal Dis 6(1):17–23PubMedCrossRef
19.
go back to reference Manfredi S, Benhamiche AM, Meny B et al (2001) Population-based study of factors influencing occurrence and prognosis of local recurrence after surgery for rectal cancer. Br J Surg 88(9):1221–1227PubMedCrossRef Manfredi S, Benhamiche AM, Meny B et al (2001) Population-based study of factors influencing occurrence and prognosis of local recurrence after surgery for rectal cancer. Br J Surg 88(9):1221–1227PubMedCrossRef
20.
go back to reference Moore HG, Riedel E, Minsky BD et al (2003) Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy. Ann Surg Oncol 10(1):80–85PubMedCrossRef Moore HG, Riedel E, Minsky BD et al (2003) Adequacy of 1-cm distal margin after restorative rectal cancer resection with sharp mesorectal excision and preoperative combined-modality therapy. Ann Surg Oncol 10(1):80–85PubMedCrossRef
21.
go back to reference Olson RM, Perencevich NP, Malcolm AW et al (1980) Patterns of recurrence following curative resection of adenocarcinoma of the colon and rectum. Cancer 45(12):2969–2974PubMedCrossRef Olson RM, Perencevich NP, Malcolm AW et al (1980) Patterns of recurrence following curative resection of adenocarcinoma of the colon and rectum. Cancer 45(12):2969–2974PubMedCrossRef
22.
go back to reference Phillips RK, Hittinger R, Blesovsky L et al (1984) Local recurrence following ‘curative’ surgery for large bowel cancer: I. The overall picture. Br J Surg 71(1):12–16PubMedCrossRef Phillips RK, Hittinger R, Blesovsky L et al (1984) Local recurrence following ‘curative’ surgery for large bowel cancer: I. The overall picture. Br J Surg 71(1):12–16PubMedCrossRef
23.
go back to reference Steele G Jr, Ellenberg S, Ramming K et al (1982) CEA monitoring among patients in multi-institutional adjuvant G.I. therapy protocols. Ann Surg 196(2):162–169PubMedCrossRef Steele G Jr, Ellenberg S, Ramming K et al (1982) CEA monitoring among patients in multi-institutional adjuvant G.I. therapy protocols. Ann Surg 196(2):162–169PubMedCrossRef
24.
go back to reference Wang WS, Lin JK, Chiou TJ et al (2000) Preoperative carcinoembryonic antigen level as an independent prognostic factor in colorectal cancer: Taiwan experience. Jpn J Clin Oncol 30(1):12–16PubMedCrossRef Wang WS, Lin JK, Chiou TJ et al (2000) Preoperative carcinoembryonic antigen level as an independent prognostic factor in colorectal cancer: Taiwan experience. Jpn J Clin Oncol 30(1):12–16PubMedCrossRef
25.
go back to reference Park KJ, Choi HJ, Roh MS et al (2005) Intensity of tumor budding and its prognostic implications in invasive colon carcinoma. Dis Colon Rectum 48(8):1597–1602PubMedCrossRef Park KJ, Choi HJ, Roh MS et al (2005) Intensity of tumor budding and its prognostic implications in invasive colon carcinoma. Dis Colon Rectum 48(8):1597–1602PubMedCrossRef
26.
go back to reference Lee YT (1995) Local and regional recurrence of carcinoma of the colon and rectum: I. Tumour-host factors and adjuvant therapy. Surg Oncol 4(6):283–293PubMedCrossRef Lee YT (1995) Local and regional recurrence of carcinoma of the colon and rectum: I. Tumour-host factors and adjuvant therapy. Surg Oncol 4(6):283–293PubMedCrossRef
27.
go back to reference Nagtegaal ID, van de Velde CJ, van der Worp E et al (2002) Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol 20(7):1729–1734PubMedCrossRef Nagtegaal ID, van de Velde CJ, van der Worp E et al (2002) Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol 20(7):1729–1734PubMedCrossRef
28.
go back to reference Ptok H, Marusch F, Meyer F et al (2007) Impact of anastomotic leakage on oncological outcome after rectal cancer resection. Br J Surg 94(12):1548–1554PubMedCrossRef Ptok H, Marusch F, Meyer F et al (2007) Impact of anastomotic leakage on oncological outcome after rectal cancer resection. Br J Surg 94(12):1548–1554PubMedCrossRef
29.
go back to reference Umpleby HC, Fermor B, Symes MO, Williamson RC (1984) Viability of exfoliated colorectal carcinoma cells. Br J Surg 71(9):659–663PubMedCrossRef Umpleby HC, Fermor B, Symes MO, Williamson RC (1984) Viability of exfoliated colorectal carcinoma cells. Br J Surg 71(9):659–663PubMedCrossRef
30.
go back to reference Lee WS, Yun SH, Roh YN et al (2008) Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer. World J Surg 32:1124–1129PubMedCrossRef Lee WS, Yun SH, Roh YN et al (2008) Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer. World J Surg 32:1124–1129PubMedCrossRef
31.
go back to reference Mamounas EP (2000) Adjuvant chemotherapy for stage II colon cancer: the time has come. Eur J Surg Oncol 26(8):725–729PubMedCrossRef Mamounas EP (2000) Adjuvant chemotherapy for stage II colon cancer: the time has come. Eur J Surg Oncol 26(8):725–729PubMedCrossRef
32.
go back to reference Morris M, Platell C, de Boer B et al (2006) Population-based study of prognostic factors in stage II colonic cancer. Br J Surg 93(7):866–871PubMedCrossRef Morris M, Platell C, de Boer B et al (2006) Population-based study of prognostic factors in stage II colonic cancer. Br J Surg 93(7):866–871PubMedCrossRef
33.
go back to reference Posner MR, Bleday R, Huberman M et al (1993) Impact of combined modality therapy on the treatment of adenocarcinoma of the colon. Semin Surg Oncol 9(1):33–38PubMedCrossRef Posner MR, Bleday R, Huberman M et al (1993) Impact of combined modality therapy on the treatment of adenocarcinoma of the colon. Semin Surg Oncol 9(1):33–38PubMedCrossRef
34.
go back to reference Wein A, Hahn EG, Merkel S, Hohenberger W (2000) Adjuvant chemotherapy for stage II (Dukes’ B) colon cancer: too early for routine use. Eur J Surg Oncol 26(8):730–732PubMedCrossRef Wein A, Hahn EG, Merkel S, Hohenberger W (2000) Adjuvant chemotherapy for stage II (Dukes’ B) colon cancer: too early for routine use. Eur J Surg Oncol 26(8):730–732PubMedCrossRef
Metadata
Title
Local recurrence after curative resection in patients with colon and rectal cancers
Authors
H. R. Yun
L. J. Lee
J. H. Park
Y. K. Cho
Y. B. Cho
W. Y. Lee
H. C. Kim
H. K. Chun
S. H. Yun
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 11/2008
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-008-0530-0

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