Abstract

Purpose: Recurrence of colorectal cancers is considered to be one of the greatest post-surgical complications that is affected by various factors. This study design to investigate the prognostic factors that affect the recurrence and survival of patients with colon and rectal cancer.

Methods: A retrospective study was performed in 380 patients with colon and rectal cancer who underwent surgery; type of surgery, tumor size, differentiation grade, proximal, distal and radial, marginal involvement, total number of excision lymph nodes, number of involved lymph nodes and tumor stage was recorded. Also, the incidence of recurrence and metastasis was recorded during the study.

Results: 380 patients with mean age of 57.11 were enrolled to the study. 152 patients with an average age of 57.57 were diagnosed with colon cancer. Recurrence and metastasis occurred in 2 patients (1.3%) and 5 patients (3.3%), respectively. 18 patients (11.8%) died due to colon cancer. 228 patients with a mean age of 56.81 had rectal cancer. Recurrence was seen in 19 patients (8.3%) and metastasis in 33 patients (14.5%). 38 patients (16.7%) died due to rectal cancer. Tumor size and involved lymph nodes were independent prognosis factors of recurrence and metastases of colon cancer. Only involved lymph nodes were associated with death due to colon cancer. Independent prognostic factors of rectal cancer metastasis included albumin and age. The total number of excision lymph nodes was the only predictor factor of tumor recurrence and death in rectal cancer. The median survival time of colon and rectal cancers were 90 and 110 months, respectively.

Conclusion: The size of the tumor and the number of involved lymph nodes were independent prognostic factors for recurrence and metastasis of colon cancer. Also, the number of involved lymph nodes was associated with colon cancer related death. In the case of rectal cancer, albumin levels and age predicted metastases. Only total number of excision lymph nodes had reverse relationship with recurrence and rectal cancer related death.

Keywords: Colorectal Neoplasms; Neoplasm Recurrence; Neoplasm Metastasis; Lymphatic Metastasis; Survival

References

1. Arredondo J., et al. “Prognosis factors for recurrence in patients with locally advanced rectal cancer preoperatively treated with chemoradiotherapy and adjuvant chemotherapy”. Diseases of the Colon and Rectum4 (2013): 416-421.
2. Attaallah W., et al. “Prognostic impact of the metastatic lymph node ratio on survival in rectal cancer”. Annals of Coloproctology3 (2013): 100-105.
3. Hao Y-DL and Xia Z-J. “A prognostic model to predict survival in stage III colon cancer patients based on histological grade, preoperative carcinoembryonic antigen level and the neutrophil lymphocyte ratio”. Asian Pacific Journal of Cancer Prevention2 (2015): 747-751.
4. Koelzer VH., et al. “Heterogeneity analysis of metastasis associated in colon cancer 1 (MACC1) for survival prognosis of colorectal cancer patients: a retrospective cohort study”. BMC Cancer1 (2015): 160.
5. Ishihara S., et al. “Impact of Primary Tumor Location on Postoperative Recurrence and Subsequent Prognosis in Nonmetastatic Colon Cancers: A Multicenter Retrospective Study Using a Propensity Score Analysis”. Annals of Surgery5 (2017): 917-921.
6. Xu G., et al. “A 15-gene signature for prediction of colon cancer recurrence and prognosis based on SVM”. Gene 604 (2017): 33-40.
7. Wray CM., et al. “Tumor subsite location within the colon is prognostic for survival after colon cancer diagnosis”. Diseases of the Colon and Rectum8 (2009): 1359-1366.
8. Patel SA., et al. “Early stage rectal cancer: clinical and pathologic prognostic markers of time to local recurrence and overall survival after resection”. Diseases of the Colon and Rectum4 (2014): 449.
9. Westberg K., et al. “Time to local recurrence as a prognostic factor in patients with rectal cancer”. European Journal of Surgical Oncology (EJSO)5 (2015): 659-666.
10. Asoglu O., et al. “Prognostic and predictive factors after surgical treatment for locally recurrent rectal cancer: a single institute experience”. European Journal of Surgical Oncology (EJSO)10 (2007): 1199-1206.
11. Compton CC. “Pathologic prognostic factors in the recurrence of rectal cancer”. Clinical Colorectal Cancer3 (2002): 149-160.
12. Larsen SG., et al. “Hydronephrosis as a prognostic factor in pelvic recurrence from rectal and colon carcinomas”. The American Journal of Surgery1 (2005): 55-60.
13. Zhou D., et al. “Prognostic value of lymph node ratio in survival of patients with locally advanced rectal cancer”. Canadian Journal of Surgery4 (2015): 237.
14. Jeong S., et al. “Postoperative carcinoembryonic antigen level has a prognostic value for distant metastasis and survival in rectal cancer patients who receive preoperative chemoradiotherapy and curative surgery: a retrospective multi-institutional analysis”. Clinical and Experimental Metastasis8 (2016): 809-816.
15. Cai Y., et al. “Prognostic factors associated with locally recurrent rectal cancer following primary surgery”. Oncology letters1 (2014): 10-16.
16. Parnaby C., et al. “Prognostic value of lymph node ratio and extramural vascular invasion on survival for patients undergoing curative colon cancer resection”. British Journal of Cancer2 (2015): 212-219.
17. Petrelli F., et al. “Prognostic survival associated with left-sided vs right-sided colon cancer: a systematic review and meta-analysis”. JAMA Oncology2 (2017): 211-219.
18. Sinicrope FA., et al. “Obesity is an independent prognostic variable in colon cancer survivors”. Clinical Cancer Research6 (2010): 1884-1893.
19. Fang Y-J., et al. “Prognostic impact of ERβ and MMP7 expression on overall survival in colon cancer”. Tumor Biology6 (2010): 651-658.
20. Trivedi H., et al. “Prognostic factors of overall survival for patients with stage II colon cancer”. Acta Medica Academica2 (2014): 134.
21. Pacelli F., et al. “Locally recurrent rectal cancer: prognostic factors and long-term outcomes of multimodal therapy”. Annals of Surgical Oncology1 (2010): 152-162.

Citation

Citation: Seyed Mohammad Kazem Tadayon., et al. “Survey the Prognostic Factors of Recurrence and Survival in Patients with Colorectal Cancer". Acta Scientific Gastrointestinal Disorders 3.11 (2020): 28-34.

Copyright

Copyright: © 2020 Seyed Mohammad Kazem Tadayon., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.