Clinicopathologic Factors Affecting Recurrence after Curative Surgery for Stage I Colorectal Cancer
금민애, 임석병, 김선아, 윤용식, 김찬욱, 유창식, 김진천,
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금민애 ( Keum Min-Ae )
University of Ulsan College of Medicine Department of Surgery
임석병 ( Lim Seok-Byung )
University of Ulsan College of Medicine Department of Surgery
김선아 ( Kim Sun-A )
University of Ulsan College of Medicine Department of Pathology
윤용식 ( Yoon Yong-Sik )
University of Ulsan College of Medicine Department of Surgery
김찬욱 ( Kim Chan-Wook )
University of Ulsan College of Medicine Department of Surgery
유창식 ( Yu Chang-Sik )
University of Ulsan College of Medicine Department of Surgery
김진천 ( Kim Jin-Cheon )
University of Ulsan College of Medicine Department of Surgery
KMID : 0356720120280010049
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.
키워드
Colorectal neoplasms; Recurrence; Risk factors
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