J Korean Soc Coloproctol.  2012 Feb;28(1):49-55. 10.3393/jksc.2012.28.1.49.

Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer

• Keum MA
• Lim SB
• Kim SA
• Yoon YS
• Kim CW
• Yu CS
• Kim JC

• KMID: 2025911
• DOI: http://doi.org/10.3393/jksc.2012.28.1.49

Abstract

PURPOSE
The objective of the current study was to identify the clinicopathological risk factors affecting recurrence after a curative resection for stage I colorectal cancer.
METHODS
We retrospectively studied 434 patients who underwent a curative resection for stage I colorectal cancer between January 1999 and December 2004. Postoperative oral chemotherapy was performed in 189 patients (45.3%). The following prognostic factors were correlated with recurrence: age, gender, preoperative carcinoembryonic antigen level, location of tumor, T stage, size of tumor, histologic differentiation, growth pattern, and lymphovascular invasion. The median follow-up duration was 65 months.
RESULTS
The overall recurrence rate was 4.6% (20/434). The median time to recurrence was 33 months. Two-thirds of the recurrence occurred more than two years after surgery. Risk factors associated with recurrence were rectal cancer (P = 0.009), T2 stage (P = 0.010), and infiltrative growth pattern (P = 0.020). A Cox proportional hazards regression analysis demonstrated that the infiltrative growth pattern was an independent predictor for recurrence. Tumor cell budding was observed in all pathologic reviews with recurrence.
CONCLUSION
Long-term follow-up is necessary for stage I colorectal patients with high risk factors like rectal cancer, T2 stage, and infiltrative growth pattern.

Keyword

Colorectal neoplasms; Recurrence; Risk factors

MeSH Terms

Carcinoembryonic Antigen
Colorectal Neoplasms
Follow-Up Studies
Humans
Rectal Neoplasms
Recurrence
Retrospective Studies
Risk Factors
Carcinoembryonic Antigen