Prognostic Factors for Isolated Locoregional Recurrences in Colon Cancer and Survival After Salvage Surgery: a Cohort Study


Akgun E. , Yoldas T. , Caliskan C. , Karabulut B., Doganavsargil B. , Akarca U. S.

INDIAN JOURNAL OF SURGERY, cilt.80, ss.428-434, 2018 (SCI İndekslerine Giren Dergi)

  • Cilt numarası: 80 Konu: 5
  • Basım Tarihi: 2018
  • Doi Numarası: 10.1007/s12262-017-1623-1
  • Dergi Adı: INDIAN JOURNAL OF SURGERY
  • Sayfa Sayısı: ss.428-434

Özet

The purpose of this study was to establish the factors affecting development of locoregional recurrence (LR) and survival following salvage surgery in patients operated on for stage I-III colon adenocancer with curative purposes and using a standard technique by an experienced surgeon in elective circumstances. This was a cohort study of patients diagnosed with colon cancer, operated on (n=312) between January 2003 and 2015. Isolated LR was detected in 15 patients (4.8%) among 312 consecutive patients (99.7% R-0 resection) in a mean follow-up period of 60.5months. The most important prognostic factors affecting LR development were found to be R-1 resection, pT(4) tumor (tm), postoperative development of morbidity, T-4 tm, N-2 tm, and mucinous tm. All patients who were detected to have isolated LR were re-operated with curative intent (80% R-0). Prognostic factors for cancer-specific survival (CSS) in those cases were development of distant metastasis, localization of the recurrent tumor (pelvis), and symptomatic patient. Mean survival in the whole series was 125.2months and 5-year CSS was 89%, while respective values in cases with development of LR were 47.4months and 54.4%, respectively. Although development of isolated LR worsens the prognosis considerably, a long survival and even cure can be provided in some patients. Survival is closely related with resectability and localization of the recurrent tumor and development of distant metastasis. Close follow-up of high-risk patients, early diagnosis and treatment in patients with development of recurrence, experienced team and standardized curative surgery, and a multidisciplinary approach improve the prognosis.