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J Korean Soc Coloproctol. 2012 Feb;28(1):49-55. English. Original Article.
Keum MA , Lim SB , Kim SA , Yoon YS , Kim CW , Yu CS , Kim JC .
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jckim@amc.seoul.kr
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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.

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