Loco-regional recurrence from colon cancer: a population-based study

• Published in: Annals of surgical oncology 2007-02, Vol.14 (2), p.432-440
• Main Authors: Sjövall, Annika, Granath, Fredrik, Cedermark, Björn, Glimelius, Bengt, Holm, Torbjörn
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - epidemiology; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Colon cancer; Colonic Neoplasms - epidemiology; Colonic Neoplasms - surgery; Female; Humans; Incidence; Loco-regional recurrence; Male; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Neoplasm Recurrence, Local - epidemiology; Population-based; Risk Factors; Survival Analysis; Sweden - epidemiology; Treatment Outcome
• ISSN: 1068-9265; 1534-4681; 1534-4681
• DOI: 10.1245/s10434-006-9243-1

The survival after colon cancer surgery has not improved to the same extent as after rectal cancer treatment and studies on loco-regional recurrence after colon cancer surgery are scarce. The aim of this study was to assess the problem of loco-regional recurrence after potentially curative resections for colon cancer, regarding incidence, risk factors, management, and outcome. All 1,856 patients submitted to potentially curative surgery for colon cancer in the Stockholm/Gotland region in Sweden between 1996 and 2000 were followed until January 2005 or until death. Follow-up data were prospectively collected. Risk factors for loco-regional recurrences were analyzed, treatment and outcome for patients with recurrence was studied. The cumulative 5-year incidence of loco-regional recurrence was 11.5%. Tumor locations in the right flexure and in the sigmoid colon, bowel perforation and emergent surgery were identified as independent risk factors for loco-regional recurrence. The risk also increased with increasing T- and N-stage. The median survival for all 192 patients with loco-regional recurrence was 9 months. Surgery was performed in 110 (57%) patients. In 23 (12%) patients a complete tumor clearance was achieved and the estimated 5-year survival in this group was 43%. Loco-regional recurrence from colon cancer is a significant clinical problem. A multidisciplinary treatment approach, including preoperative staging, a complete resection of the recurrence and more effective adjuvant treatments may improve the outcome.