Factors associated with short recurrence-free survival in completely resected colon cancer

Abstract

Background: Several factors could affect disease recurrence in surgically resected colon cancer. While the role of certain factors such as cancer stage and grade is well established, the role of other factors (e.g., histological subtypes) is yet to be determined. Objective:Therefore, we conducted a study to evaluate the impact of several factors in recurrence-free survival (RFS) in patients who were disease free following surgical resection of the colon cancer. Design/Methods: Data were collected for patients with Stage I–III colon cancer who underwent complete surgical resection of the tumor between January 2010 and December 2015 in our institution. A total of 90 subjects met the inclusion criteria and were included in the study. The following factors were collected at the time of surgical resection of the colonic tumor: patient’s age, gender, colon cancer stage, grade and histological subtype, body mass index, hemoglobin A1c, and smoking history. Results: A total of 28 patients (31%) developed recurrence and had a mean follow-up time of 19.8 months (range: 2–54.4 months). Median RFS was 54.4 months with a 5-year RFS of 49%. Advanced colonic cancer stage and mucinous histological subtype were associated with shorter RFS with an HR of 2.37, 95% CI = 1.38–4.06, and 95% CI = 1.02–5.90, respectively. Current smokers or those who quit less than 15 years earlier tended to have worse RFS with an HR of 2.47, 95% CI = 0.98–6.27. Conclusion: Advanced colon cancer stage and mucinous histological subtype are independent risk factors for cancer recurrence and shorter RFS in completely resected colonic tumor.

Results of Surgical Treatment of Uncomplicated Colon Cancer. Case Series with Follow-Up

“…The local recurrence was verified in 19.2 % of cases, lower than reported after curative resection, which can reach 31 % (Alnimer et al, 2017). There is evidence that this is associated with vascular or lymphatic permeation to a number of resected lymph nodes less than 12, as well as the type of resection (R1 and R2) (Kojo et al, 2017).…”

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

“…The relationship between the recurrence interval and the use of adjuvant therapy remains unclear in the literature (Ryuk et al., 2014). It is known that adjuvant chemotherapy and tumour stage are variables closely related (Alnimer et al., 2017; Touchefeu et al., 2016) and that is why we opted to study them together. We found that regardless of whether patients received adjuvant chemotherapy, recurrence was more likely in all groups than in the least severe group (TNM I not given chemotherapy).…”

“…In contrast, the 5‐year survival rates for regional and distant stages are 70% and 15% respectively (American Cancer Society 2014; Holmes et al., 2017). Despite the various types of treatment available, the chance of recurrence and metastasis of CRC among patients is high (Alnimer et al., 2017) and it depends on disease stage (Ryuk et al., 2014; Tsai et al., 2009; Zare‐Bandamiri, Fararouei, Zohourinia, Daneshi, & Dianatinasab, 2017). Fifty per cent of patients with stage III disease will experience disease recurrence (Zhang et al., 2016), this occurring within the first 3 years after initial resection in 80% and in 90% of cases within the first 4 years (Maeda et al., 2017; Seo et al., 2013; Tsai et al., 2009).…”

“…Recurrent cancer is common, costly and lethal (Hassett et al., 2017), especially in cases of early relapse (Tsai et al., 2009), and our knowledge about factors influencing the chance of recurrence is either limited (Alnimer et al., 2017; Zare‐Bandamiri et al., 2017). Identification of predictive factors along with better treatment strategies may help reduce the probability of recurrence and raise life expectancy (Alnimer et al., 2017). In particular, a model suggesting which patients have the highest risk of recurrence might help clinicians provide more appropriate treatment to these patients.…”

Simultaneous Resection For Colon Cancer and Synchronous Liver Metastases. Case Series With Follow-Up

“…Local recurrence was verified in 19.2 % of cases, lower than reported after curative resection, which can reach 31 % (Alnimer et al, 2017). There is evidence that this is associated with vascular or lymphatic permeation; to a few resected lymph nodes (less than 12); as well as the type of resection (R1 and R2) (Kojo et al, 2017).…”