Akademik Veri Yönetim Sistemi
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)
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.