Clinical Predictors for Recurrence after Curative Resection for Colorectal Cancer - Journal of Cancer Therapy

JCT > Vol.8 No.12, December 2017

Clinical Predictors for Recurrence after Curative Resection for Colorectal Cancer ()

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DOI: 10.4236/jct.2017.812095 1,144 Downloads 3,349 Views Citations

Author(s)

Ola Røkke^1,2*, Thomas Heggelund¹, Jurate Saltyte Benth³, Marianne Steffensen Røkke⁴, Kjell Kåre Øvrebø⁵

Affiliation(s)

¹Department of Digestive Surgery, Akershus University Hospital, Lorenskog, Norway.
²Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.
³Institute of Clinical Medicine, Campus Ahus, University of Oslo, Health Services Research Unit, Akershus University Hospital, Lorenskog, Norway.
⁴Department of Head and Neck Surgery, Akershus University Hospital, Lorenskog, Norway.
⁵Department of Digestive Surgery, Haukeland University Hospital, Bergen, Norway.

ABSTRACT

Purpose: To identify clinical predictors of recurrence of colorectal cancer after curative surgical treatment. Methods: Retrospective follow-up-study of 925 consecutive patients treated with R0-resection for colorectal cancer Stage I, II and III from 1990 until 2000 with a mean follow-up of 60 ± 37 months. Predictors for cancer recurrence were identified in a pilot-sample of these patients, followed by analyses of the rest of the patients (test-sample), and finally with a concluding analyses of the entire patient group. Data were analyzed with Pearson Chi-square test (χ²), Cox regression analyses and log rank test. Results: Tumor stage (Stage I: HR 0.10 (0.05; 0.19), Stage II: HR 0.31 (0.24; 0.41)) and postoperative reoperations due to complications due to other causes than anastomotic leakage (HR 2.02 (1.21; 3.36)) were significant predictors of cancer recurrence in the multivariate Cox regression model. The association between reoperations and recurrence was strongest for the patients with the best prognosis: Stage I and Stage II-cancers. Long duration of surgery, strongly associated with blood-loss and infusions of liquid and blood-products, reoperation due to anastomotic leakage as well as right colon/transversum localization were significant at a trend-level (10%). Conclusions: Tumor stage and reoperations due to postoperative complications other than anastomotic leakage are significant predictors for recurrence after curative surgery for colorectal cancer.

KEYWORDS

Cancer, Colon, Rectum, Metastases, Predictors, Recurrence, Reoperation, Complication

Share and Cite:

Røkke, O. , Heggelund, T. , Benth, J. , Røkke, M. and Øvrebø, K. (2017) Clinical Predictors for Recurrence after Curative Resection for Colorectal Cancer. Journal of Cancer Therapy, 8, 1107-1124. doi: 10.4236/jct.2017.812095.

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