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KMID : 0356720120280010049
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Journal of the Korean Society of Coloproctology
2012 Volume.28 No. 1 p.49 ~ p.55
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Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer
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Keum Min-Ae
Lim Seok-Byung
Kim Sun-A
Yoon Yong-Sik
Kim Chan-Wook
Yu Chang-Sik
Kim Jin-Cheon
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Abstract
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Purpose: The objective of the current study was to identify the clinicopathological risk factors affecting recurrence after a curative resection for stage I colorectal cancer.
Methods: We retrospectively studied 434 patients who underwent a curative resection for stage I colorectal cancer between January 1999 and December 2004. Postoperative oral chemotherapy was performed in 189 patients (45.3%). The following prognostic factors were correlated with recurrence: age, gender, preoperative carcinoembryonic antigen level, location of tumor, T stage, size of tumor, histologic differentiation, growth pattern, and lymphovascular invasion. The median follow-up duration was 65 months.
Results: The overall recurrence rate was 4.6% (20/434). The median time to recurrence was 33 months. Two-thirds of the recurrence occurred more than two years after surgery. Risk factors associated with recurrence were rectal cancer (P = 0.009), T2 stage (P = 0.010), and infiltrative growth pattern (P = 0.020). A Cox proportional hazards regression analysis demonstrated that the infiltrative growth pattern was an independent predictor for recurrence. Tumor cell budding was observed in all pathologic reviews with recurrence.
Conclusion: Long-term follow-up is necessary for stage I colorectal patients with high risk factors like rectal cancer, T2 stage, and infiltrative growth pattern.
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KEYWORD
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Colorectal neoplasms, Recurrence, Risk factors
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