Patterns of recurrence of obstructing colon cancers after surgery for cure: a population‐based study. (18th September 2013)

• Record Type: Journal Article
• Authors: Cortet, M.; Grimault, A.; Cheynel, N.; Lepage, C.; Bouvier, A. M.; Faivre, J.
• Is Part Of: Colorectal disease. Volume 15:Number 9(2013)
• Page Start: 1100
• Page End: 1106
• Publication Date: 2013-09-18
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12268
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12268-abs-0001"> <title>Abstract</title> <sec id="codi12268-sec-0001" sec-type="section"> <title>Aim</title> <p>Little is known about patterns of recurrence in obstructing colon cancer (OCC) at a population level. The aim of this study was to determine the risk of recurrence following potentially curative surgery in OCC compared with that in uncomplicated colon cancer (CC).</p> </sec> <sec id="codi12268-sec-0002" sec-type="section"> <title>Method</title> <p>Data were obtained from the population‐based digestive cancer registry of Burgundy (France). Local and distant failure rates were calculated using actuarial methods. A multivariate analysis was performed using a Cox model.</p> </sec> <sec id="codi12268-sec-0003" sec-type="section"> <title>Results</title> <p>Obstructing colon cancer represented 8.5% of all colon cancers resected with curative intent (<italic>n </italic>=<italic> </italic>3375). The 5‐year cumulative local recurrence rate was 14.2% for OCC and 7.6% for nonobstructing CC (<italic>P </italic>=<italic> </italic>0.003). In the multivariate analysis, obstruction was an independent risk factor for local recurrence [hazard ratio 1.53 (1.01–2.34), <italic>P </italic>=<italic> </italic>0.047]. The risk of local recurrence increased with advanced stage and age at diagnosis. The 5‐year cumulative rate for distant metastases was also higher in OCC than in nonobstructing CC (36.1 <italic>vs</italic> 23.1%; <italic>P </italic><<italic> </italic>0.001). The relative risk of distant metastasis was borderline significant in the multivariate analysis [hazard ratio 1.25 (0.99–1.59), <italic>P </italic>=<italic> </italic>0.057]. Stage at diagnosis, macroscopic type of growth, period of diagnosis and sex were also significant prognostic factors. Age and subsite were not significant in the multivariate analysis.</p> </sec> <sec id="codi12268-sec-0004" sec-type="section"> <title>Conclusion</title> <p>It is possible to conduct special surveys in population‐based registries to determine the recurrence rate of CC. Recurrence remains a substantial problem and is more frequent in OCC than in nonobstructing CC. Efforts must be made to diagnose CC earlier. Mass screening is a promising approach.</p> </sec> </abstract>