Prognostic Factors for Locoregional Recurrences in Colon Cancer.


Elferink, M.A.G. and Visser, O. and Wiggers, T. and Otter, R. and Tollenaar, R.A.E.M. and Langendijk, J.A. and Siesling, S. (2012) Prognostic Factors for Locoregional Recurrences in Colon Cancer. Annals of surgical oncology, 19 (7). 2203 - 2211. ISSN 1068-9265

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Abstract:Background. There is increased interest in locoregional
recurrences of rectal cancer. Despite comparable locoregional
recurrence rates in colon cancer, only a few studies
on locoregional recurrences among colon cancer patients
have been published. This study was designed to identify
prognostic factors for locoregional recurrences among
patients with colon cancer in the Netherlands.
Methods. The study population was composed of patients
who underwent radical surgical resections for invasive
colon carcinoma, diagnosed in three regions of the Netherlands
from 2000 to 2003. The Kaplan-Meier method was
used to calculate 5-year locoregional recurrence rates
(LRR). Conditional hazard rates were estimated by the lifetable
method. Multivariate Cox regression analyses were
performed to identify prognostic factors and to calculate a
Locoregional Recurrence Risk Score (LRRS).
Results. In total 127 of 2,282 patients developed locoregional
recurrences within 5 years (LRR 6.4%). The risk of
developing a locoregional recurrence was highest at
0.5–1 year after surgery. Patients with left-sided tumors,
T3-T4 tumors, and positive lymph nodes and those who did
not receive adjuvant chemotherapy were more likely to
develop locoregional recurrences. Four risk groups based
on the LRRS were defined. Five-year LRR was 2.5% for
the very low-risk group and 25.1% for the high-risk group.
Conclusions. Although the locoregional recurrence rate in
this study was relatively low, it remains a considerable
problem. Identifying individual patients who might benefit
from adjuvant chemotherapy may reduce the locoregional
recurrence rate
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