Cancers (Oct 2021)

Tumor Size >5 cm and Harvested LNs <12 Are the Risk Factors for Recurrence in Stage I Colon and Rectal Cancer after Radical Resection

  • Hye-Sol Jung,
  • Seung-Bum Ryoo,
  • Han-Ki Lim,
  • Min Jung Kim,
  • Sang Hui Moon,
  • Ji Won Park,
  • Seung-Yong Jeong,
  • Kyu Joo Park

DOI
https://doi.org/10.3390/cancers13215294
Journal volume & issue
Vol. 13, no. 21
p. 5294

Abstract

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Recurrence can still occur even after radical resection of stage I colorectal cancer (CRC). This study aimed to identify subgroups with a high risk for recurrence in the stage I CRC. We retrospectively reviewed prospectively collected data of 1952 patients with stage I CRC after radical resection between 2002 and 2017 at our institute. 1398 (colon, 903 (64.6%), rectum, 495 (35.4%)) were eligible for analysis. We analyzed the risk factors for recurrence and survival. During the follow-up period (median: 59 months), 63 (4.6%) had a recurrence. The recurrence rate of rectal cancer was significantly higher than that of colon cancer (8.5% vs. 2.3%). Left-sided tumors, T2, tumor size >5 cm, and lymphovascular invasion were independent risk factors of colon cancer recurrence. Male, preoperative carcinoembryonic antigen (CEA) ≥2.5 ng/mL, and harvested lymph nodes (LNs) <12 were independently associated with recurrence of rectal cancer. Recurrence affected OS (5-year OS: 97.1% vs. 67.6%). Despite curative resection, survival sharply decreased with recurrence. The risk factors for recurrence were different between colon and rectal cancer. Patients with a higher risk for recurrence should be candidates for more aggressive surveillance, even in early-stage CRC.

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