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Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer

BACKGROUND: It is not clear whether stage II colon and rectal cancer have the same risk factors for recurrence. Thus, the purpose of this study was to identify the risk factors for postoperative recurrence in stage II colorectal cancer. PATIENTS AND METHODS: We retrospectively analyzed the data of 9...

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Autores principales: Wang, Liming, Hirano, Yasumitsu, Ishii, Toshimasa, Kondo, Hiroka, Hara, Kiyoka, Obara, Nao, Yamaguchi, Shigeki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066772/
https://www.ncbi.nlm.nih.gov/pubmed/32160919
http://dx.doi.org/10.1186/s12957-020-01818-7
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author Wang, Liming
Hirano, Yasumitsu
Ishii, Toshimasa
Kondo, Hiroka
Hara, Kiyoka
Obara, Nao
Yamaguchi, Shigeki
author_facet Wang, Liming
Hirano, Yasumitsu
Ishii, Toshimasa
Kondo, Hiroka
Hara, Kiyoka
Obara, Nao
Yamaguchi, Shigeki
author_sort Wang, Liming
collection PubMed
description BACKGROUND: It is not clear whether stage II colon and rectal cancer have the same risk factors for recurrence. Thus, the purpose of this study was to identify the risk factors for postoperative recurrence in stage II colorectal cancer. PATIENTS AND METHODS: We retrospectively analyzed the data of 990 patients who had undergone radical surgery for stage II colorectal cancer. Patients’ pathological features and characteristics including age, sex, family history, body mass index, tumor diameter, gross type of tumor, infiltration degree (T3/T4), tumor grade, perineural invasion, vascular invasion, lymphatic invasion, pathologic examination of lymph node number, and preoperative carcinoembryonic assay (CEA) level was compared between patients with and without recurrence. Finally, the prediction of the left and right colons was analyzed. RESULTS: The mean ages of the colon cancer and rectal cancer patients were 69.5 years and 66.4 years, respectively. In total, 508 (82.1%) and 285 (76.8%) patients were treated laparoscopically for colon cancer and rectal cancer, respectively, with median follow-up periods of 42.2 months and 41.8 months, respectively. Forty-four recurrences occurred in both the colon cancer (7.1%) and rectal cancer (11.9%) groups. The preoperative serum CEA level and T4 infiltration were significantly higher in recurrent colorectal cancer patients. The postoperative recurrence rate of left colon cancer (descending colon, sigmoid colon) was higher than that of right colon cancer (cecum, ascending colon, transverse colon) (OR 2.191, 95% CI 1.091–4.400, P = 0.027). In COX survival factor analysis of colon cancer, the left colon is one of the independent risk factors (risk ratio 5.377, 95% CI 0.216–0.88, P = 0.02). In disease-free survival (DFS), the left colon has a relatively poor prognosis (P = 0.05). However, in the COX analysis and prognosis analysis of OS, no difference was found between the left colon and the right colon. CONCLUSION: Preoperative CEA and depth of infiltration (T4) are high-risk factors associated with recurrence and are prognostic factors in stage II colorectal cancer. Left colon is also a risk factor for postoperative recurrence of stage II colon cancer.
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spelling pubmed-70667722020-03-18 Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer Wang, Liming Hirano, Yasumitsu Ishii, Toshimasa Kondo, Hiroka Hara, Kiyoka Obara, Nao Yamaguchi, Shigeki World J Surg Oncol Research BACKGROUND: It is not clear whether stage II colon and rectal cancer have the same risk factors for recurrence. Thus, the purpose of this study was to identify the risk factors for postoperative recurrence in stage II colorectal cancer. PATIENTS AND METHODS: We retrospectively analyzed the data of 990 patients who had undergone radical surgery for stage II colorectal cancer. Patients’ pathological features and characteristics including age, sex, family history, body mass index, tumor diameter, gross type of tumor, infiltration degree (T3/T4), tumor grade, perineural invasion, vascular invasion, lymphatic invasion, pathologic examination of lymph node number, and preoperative carcinoembryonic assay (CEA) level was compared between patients with and without recurrence. Finally, the prediction of the left and right colons was analyzed. RESULTS: The mean ages of the colon cancer and rectal cancer patients were 69.5 years and 66.4 years, respectively. In total, 508 (82.1%) and 285 (76.8%) patients were treated laparoscopically for colon cancer and rectal cancer, respectively, with median follow-up periods of 42.2 months and 41.8 months, respectively. Forty-four recurrences occurred in both the colon cancer (7.1%) and rectal cancer (11.9%) groups. The preoperative serum CEA level and T4 infiltration were significantly higher in recurrent colorectal cancer patients. The postoperative recurrence rate of left colon cancer (descending colon, sigmoid colon) was higher than that of right colon cancer (cecum, ascending colon, transverse colon) (OR 2.191, 95% CI 1.091–4.400, P = 0.027). In COX survival factor analysis of colon cancer, the left colon is one of the independent risk factors (risk ratio 5.377, 95% CI 0.216–0.88, P = 0.02). In disease-free survival (DFS), the left colon has a relatively poor prognosis (P = 0.05). However, in the COX analysis and prognosis analysis of OS, no difference was found between the left colon and the right colon. CONCLUSION: Preoperative CEA and depth of infiltration (T4) are high-risk factors associated with recurrence and are prognostic factors in stage II colorectal cancer. Left colon is also a risk factor for postoperative recurrence of stage II colon cancer. BioMed Central 2020-03-11 /pmc/articles/PMC7066772/ /pubmed/32160919 http://dx.doi.org/10.1186/s12957-020-01818-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Wang, Liming
Hirano, Yasumitsu
Ishii, Toshimasa
Kondo, Hiroka
Hara, Kiyoka
Obara, Nao
Yamaguchi, Shigeki
Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer
title Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer
title_full Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer
title_fullStr Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer
title_full_unstemmed Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer
title_short Left colon as a novel high-risk factor for postoperative recurrence of stage II colon cancer
title_sort left colon as a novel high-risk factor for postoperative recurrence of stage ii colon cancer
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066772/
https://www.ncbi.nlm.nih.gov/pubmed/32160919
http://dx.doi.org/10.1186/s12957-020-01818-7
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