Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Int J Colorectal Dis. 2024 Jul 12;39(1):105. doi: 10.1007/s00384-024-04684-x.
Few studies have focused on anastomotic recurrence (AR) in colon cancer. This study aimed to clarify the association of resection margin distance with AR and compare the prognosis with nonanastomotic local recurrence (NAR).
This retrospective cohort study included the clinical data of patients who underwent radical colon cancer surgery between January 1, 2009, and December 31, 2019.
A total of 1958 colon cancer patients were included in the study. 34 of whom (1.7%) had AR and 105 of whom (5.4%) had NAR. Multivariate analysis revealed that the lower distal resection margin distance, advanced N stage, and number of lymph nodes dissected were risk factors for AR. In the proximal resection margin, the risk of AR was lowest at a distance of 6 cm or greater, with a 3-year rate of 1.3%. In the distal resection margin, the 3-year AR risk increased rapidly if the distance was less than 3 cm. The prognosis of patients in the AR group was similar to that of patients in the NAR group, regardless of synchronous distant metastases. Furthermore, the radical surgery rate for AR was significantly higher than that for NAR, but the prognosis of AR was comparable to that of NAR.
The distal resection margin distance, advanced N stage, and less number of lymph nodes dissected are associated with AR of colon cancer. The prognosis of patients with AR was similar to that of patients with NAR.
Clinical Trial Numbers NCT04074538 ( clinicaltrials.gov ), August 26, 2019, registered, retrospectively registered.
鲜有研究聚焦于结肠癌的吻合口复发（AR）。本研究旨在阐明切缘距离与 AR 的关联，并与非吻合口局部复发（NAR）的预后进行比较。
本回顾性队列研究纳入了 2009 年 1 月 1 日至 2019 年 12 月 31 日期间接受根治性结肠癌手术的患者的临床数据。
共纳入 1958 例结肠癌患者，其中 34 例（1.7%）发生 AR，105 例（5.4%）发生 NAR。多因素分析显示，远端切缘距离较低、较晚的 N 分期和淋巴结清扫数目是 AR 的危险因素。在近端切缘处，切缘距离 6cm 或以上时 AR 风险最低，3 年发生率为 1.3%。在远端切缘处，如果距离小于 3cm，则 AR 的 3 年风险迅速增加。AR 组患者的预后与 NAR 组患者相似，无论是否存在同步远处转移。此外，AR 的根治手术率显著高于 NAR，但 AR 的预后与 NAR 相当。
远端切缘距离、较晚的 N 分期和淋巴结清扫数目较少与结肠癌的 AR 相关。AR 患者的预后与 NAR 患者相似。
临床试验编号 NCT04074538（clinicaltrials.gov），于 2019 年 8 月 26 日注册，为回顾性注册。
