TITLE:
Clinical Predictors for Recurrence after Curative Resection for Colorectal Cancer
AUTHORS:
Ola Røkke, Thomas Heggelund, Jurate Saltyte Benth, Marianne Steffensen Røkke, Kjell Kåre Øvrebø
KEYWORDS:
Cancer, Colon, Rectum, Metastases, Predictors, Recurrence, Reoperation, Complication
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.12,
December
7,
2017
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.