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The journal «ONCOSURGERY» 2013, Vol.5, No 1

Risk factors for recurrence in patients with colon cancer

Sokolov AA2, Akhmetshina VM2,Butenko AV1, Privezentsev SA2

1) PA Herzen Moscow Cancer Research Institute,
2) Moscow City Oncological Hospital N62,
Moscow, Russia
Contact: Akhmetshina Venera Mullanurovna, e-mail:

The article describes the risk factors for recurrence in patients with colon cancer (CC).

Materials and methods: data base of MCOH 62 from the period from 2004 to 2008 was retrospectively analyzed. The study included 265 patients with stage I–III primary colon cancer. All patients had R0 surgery for primary tumor.

Results: the majority of patients 199 (44.9%) with CC had stage II disease. The most frequent localization of CC was sigmoid colon – 110 cases (41.5%). In majority of cases 109 (41.1%) the depth of tumor invasion was T3. According to morphological studies 175 patients (66.0%) had no lymph node metastases, regional metastases presented in 90 patients (34.0%).

For 265 patients locoregional recurrence (LRR) took place in 36 (13.6%) cases, locoregional recurrence and distant metastases in 10 cases (38%), distant metastases alone were diagnosed in 21 patient (7.9%).

Five-year disease-free survival in the study group was 67.3% (95% confidence interval 59.9–74.7%). Median of locoregional recurrence was 20.4 months, locoregional recurrence with distant metastases – 24.2 months and the median of distant metastase appearing was 23.8 months.

5-year tumor-specific survival in patients with colon cancer was – 70.1% (95% confidence interval 63.6–76.6%). The median duration of cumulative tumor-specific survival in the study group was 79.9 months.

Multifactorial statistical analysis revealed significant differences in the incidence of total return of the disease (TRD) (χ2; p=0.003), locoregional recurrence with distant metastases (χ2; p=0.009) and locoregional recurrence alone (χ2; p=0.016), depending on the T status of the patients. Significant differences in the incidence of TRD (χ2; p=0.029), LRR and LRR with metastases (χ2; p=0.035) were identified also depending on the lymph nodes status.

Conclusion. Thereby the incidence of recurrent colon cancer directly depends on depth of primary tumor invasion and regional metastasis to lymph nodes. The influence of such factors as sex of patient, method of treatment, proximal and distal resection margins, lymphadenectomy extent ≥12 lymph nodes, histologic differentiation and side of tumor localization had no prognostic value in our work.

KEY WORDS: colon cancer, colorectal cancer, recurrence, locoregional recurrence, distant metastasis, risk factors.


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