Sigeki Yamaguti, Professor, Yasumitu Hirano, PhD, Toshimasa Ishii, PhD, Hiroka Konndou, Kiyoka Hara, Asami Suzuki, Sinntarou Isikawa, Takuhisa Okada, Nao Obara, Sinyiti Sakuramoto, Kouzyun Okamoto, Isamu Koyama, Liming Wang. Saitama medical university international medical center
Background: The risk factors of recurrence in patient with stage II colorectal cancer have not been clarified in Japan, and the indications for adjuvant chemotherapy have also not been determined. In addition, it is not clear whether stage II colon and rectal cancer have the same risk factors for recurrence. The aim of the present study was to identify the risk factors of postoperative recurrence in stage II colorectal cancer.
Patients and Methods: We retrospectively reviewed a database of 990 patients who had undergone curative surgery for stage II colorectal cancer in our hospital between 2007 and 2018. There were 619 patients with colon cancer and 371 patients with rectal cancer. Patients characteristics and pathological features including age, gender, family history, BMI, tumor diameter, gross type of tumor, infiltration degree (T3 / T4), tumor grade, perineural invasion, vascular invasion, lymphatic invasion, pathologic examination of lymph node number and pre-operative carcinoembryonic assay (CEA) level were compared in patients with recurrence and in patients without recurrence.
Results: The mean age of patients with colon cancer was 69.5 years and 66.4 years with rectal cancer. 508 cases (82.1%) were treated laparoscopically for colon cancer, and 285 cases (76.8%) for rectal cancer. The median follow-up period for colon cancer was 42.2 months and 41.8 months for rectal cancer. Forty-four recurrences occurred in colon cancer (7.1%), and forty-four recurrences occurred in the rectal cancer (11.9%). The pre-operative serum CEA level was significantly high in recurrent colorectal cancer patients. The proportion of T4 was also significantly high in recurrent patients. In addition, higher BMI, larger tumor diameter, poorly differentiated adenocarcinoma, and lympho-vascular invasion were also thought to be risk factors of recurrence in rectal cancer patients.
Conclusion: Our study showed that serum CEAlevel and infiltration degree (T4) could be used as prognostic factors that suggest a higher risk for recurrence in patients with colorectal cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93566
Program Number: P324
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster