Analysis of Recurrent Pattern of Colorectal Cancer after Radical Treatment / 中国肿瘤临床

ABSTRACT

Objective: To study the influence of clinicopathologic factors on the recurrent pattern of colorectal cancer after radical treatment. Methods: There were 464 consecutive patients with colorectal cancer treated with radical surgery between January 1998 and December 2002 in our hospital. The clinicopathologic features of 90 patients with relapse of colorectal cancer after radical surgery were analyzed. According to the interval between radical surgery and recurrence, these 90 patients were divided into subgroups, the early recurrent group (within 30 months after surgery) and the late recurrent group (more than 30 months after surgery). Chi-square test was used for univariate analysis, and the Logistic regression model was performed for multivariate analysis. Result: There were 78 (86%) patients in the early recurrent group and 12 (14%) patients in the late recurrent group. The median time of recurrence was 17.4 months. The median recurrent time in stage I patients was 35.1 months, 13.6 months in stage II patients, and 12.9 months in stage III patients, respectively. Univariate analysis showed that the depth of penetration, the number of positive lymph nodes, and the gross appearance of tumor were predictors for early recurrence. Multivariate analysis revealed that the depth of penetration (T category) of the primary tumor significantly predicted for early recurrence (P= 0.049). Conclusion: A great proportion of recurrence in patients with colorectal cancer occurred within 30 months after radical treatment, but the late recurrence which occurs at more than 30 months after radical surgery should not be neglected. Patients with different patterns of recurrence had different intervals between radical surgery and recurrence. DM (distant metastasis) occurs earlier than LR (local recurrence). The depth of penetration of the primary tumor is an independent predictor for early recurrence of colorectal cancer patients after radical surgery.