[Multivariate regression analysis of recurrence following curative surgery for colorectal cancer].
OBJECTIVE
Recurrence is a very important prognostic factor for colorectal cancer patients after operation. The selection of patients for individualized follow-up and adjuvant therapy after curative resection of colorectal carcinoma depends on prognostic factors for recurrence. The objective of this study was to investigate the clinicopathologic factors related to recurrence following curative surgery for colorectal cancer.


METHODS
The clinicopathologic factors and follow-up data of 692 cases of colorectal cancers after surgical treatment from 1991 to 1999 were retrospectively analyzed by univariate and multivariate methods.


RESULTS
The overall 3-year and 5-year survival rates were 33.1% and 19.7% in recurrent group, and 92.8% and 86.1% in nonrecurrent group, respectively. Univariate analysis showed that Dukes' stage, lymph node metastasis, tumor location, histological differentiation, gross findings and depth of bowel wall invasion were significantly associated with recurrence after operation. Multivariate analysis showed that lymph node metastasis and tumor location were prognostic factors for recurrence after operation. In separate analysis of distant metastasis and local recurrence with multivariate method, lymph node metastasis was an prognostic variable for both distant metastasis and local recurrence. Depth of bowel wall invasion was associated with distant metastasis, and tumor location was associated with local recurrence.


CONCLUSIONS
Lymph node metastasis is the most important prognostic factor for recurrence or distant metastasis and local recurrence after operation for the patients with colorectal carcinoma. Depth of bowel wall invasion is an important prognostic factor for distant metastasis. Rectal cancer patients should be considered to have additional risks for local recurrence.
Liang
Jun-Lin
JL
Department of Abdominal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China. ljl_nn@163.com
Wan
De-Sen
DS
Pan
Zhi-Zhong
ZZ
Zhou
Zhi-Wei
ZW
Chen
Gong
G
Li
Li-Ren
LR
Lu
Zhen-Hai
ZH
Wu
Xiao-Jun
XJ
D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate