Khan Shah Zeb, Fatima Ismat
Department of Clinical Oncology, Bannu Institute of Nuclear Medicine Oncology and Radiotherapy (BINOR), Bannu, Pakistan.
Department of Clinical Research, Institute of Nuclear Medicine Oncology, Lahore, Pakistan.
J Taibah Univ Med Sci. 2020 Apr 3;15(3):232-237. doi: 10.1016/j.jtumed.2020.03.004. eCollection 2020 Jun.
We conducted this study to determine the factors associated with early postoperative recurrence in colon cancer patients treated with curative intent.
All consecutive patients who underwent curative resection for colon cancer between January 2014 and December 2016 were reviewed. All patients received either adjuvant chemotherapy or follow-up at the Bannu Institute of Nuclear Medicine Oncology and Radiotherapy (BINOR). The patients lived in rural areas of southern Khyber Pakhtunkhwa province.
We enrolled 72 patients, 28 of whom experienced a postoperative recurrence within 2 years (early recurrence). In univariate analysis, postoperative early relapse was significantly correlated with advanced age (>60 years, p = 0.030), nodal status (p = 0.012), pathological stage (p = 0.013), number of nodes removed (p < 0.001), and perineural invasion ( = 0.044). In multivariate analysis, age more than 60 years (p = 0.031) and fewer than 12 lymph nodes removed (p = 0.003) were independent predictors for early recurrence. The liver was the most common site of recurrence (42.8%) in this study.
Our results showed that advanced age and the removal of fewer than 12 lymph nodes during surgery were significant predictors for early postoperative recurrence. Identification of high-risk patients during follow-up with enhanced therapeutic modalities can improve disease-free survival.
我们开展本研究以确定接受根治性治疗的结肠癌患者术后早期复发的相关因素。
回顾了2014年1月至2016年12月期间所有接受结肠癌根治性切除术的连续患者。所有患者均在班努核医学肿瘤学与放射治疗研究所(BINOR)接受辅助化疗或随访。这些患者生活在开伯尔-普赫图赫瓦省南部农村地区。
我们纳入了72例患者,其中28例在2年内出现术后复发(早期复发)。单因素分析显示,术后早期复发与高龄(>60岁,p = 0.030)、淋巴结状态(p = 0.012)、病理分期(p = 0.013)、切除的淋巴结数量(p < 0.001)以及神经周围侵犯(p = 0.044)显著相关。多因素分析显示,年龄超过60岁(p = 0.031)和切除的淋巴结少于12个(p = 0.003)是早期复发的独立预测因素。在本研究中,肝脏是最常见的复发部位(42.8%)。
我们的结果表明,高龄和手术中切除的淋巴结少于12个是术后早期复发的重要预测因素。在随访期间识别高危患者并采用强化治疗模式可提高无病生存期。