Tehran University Medical Journal (Jan 2014)

Evaluation of recurrent colorectal carcinoma after curative resection

  • Amir Keshvari ,
  • Mohammad Sadegh Fazeli ,
  • Alireza Kazemeini ,
  • Alipasha Meysamie ,
  • Mohammad Kazem Nouri Taromlou

Journal volume & issue
Vol. 71, no. 10
pp. 643 – 651

Abstract

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Background: Colorectal carcinoma is considering as a curable disease. Treatment of recurrent cases is hard and sometimes impossible. Evaluation of the rate and affecting factors of recurrence in each hospital would help to decreasing recurrent cases. The aim of this study is evaluation of the rate, clinical and pathologic features, and outcome of recurrent colorectal carcinoma in a referral teaching hospital in Tehran. Methods: Clinical data of 166 curative resections of colorectal carcinoma who were operated between Mehr 1384 and Mehr 1388 (between 23 September 2005 and 23 September 2009) in Imam Khomeini Hospital and were accessible for follow up was collected. Follow up data was collected prospectively up to Farvardin 1391 (19 April 2012). Forty nine recurrences were happened in this period. We compared recurrent and non-recurrent cases for different variables Results: Average age of the patients was 53.5 years, and 47% of them were female. The median time to the diagnosis of recurrent disease was 12 months (range 1 months to 54 months). There were no significant differences between recurrent and non-recurrent patients about age, sex, sub-site of the tumor and sub-type of primary operation. Rate of overall recurrence, local recurrence and distant metastasis were 29.5%, 15.7% and 12.1% respectively. Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%). Rate of curative re-resection was about 25%. Overall survival of the recurrent patients who underwent surgery was better than who underwent chemo or radiotherapy (66.7% vs. 56.8%). Median survival time of recurrent patients after primary surgery was 28 months, and after diagnosis was 12 months (9.28- 14.72,95% CI). Conclusion: In this study the rate of overall recurrence was 29.5%. Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%).

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