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Long-term outcomes of resection for locoregional recurrence of colon cancer: A retrospective descriptive cohort study.
Chesney, Tyler R; Metz, Jeffrey J; Nadler, Ashlie; Quereshy, Fayez A; Ashamalla, Shady; Acuna, Sergio A; Swallow, Carol J.
Afiliación
  • Chesney TR; Department of Surgery, University of Toronto, Toronto, Canada; Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
  • Metz JJ; Division of General Surgery, Western University, London, Canada.
  • Nadler A; Department of Surgery, University of Toronto, Toronto, Canada; Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada.
  • Quereshy FA; Department of Surgery, University of Toronto, Toronto, Canada; Division of General Surgery, University Healthy Network, Toronto, Canada.
  • Ashamalla S; Department of Surgery, University of Toronto, Toronto, Canada; Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada.
  • Acuna SA; Department of Surgery, University of Toronto, Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Canada.
  • Swallow CJ; Department of Surgery, University of Toronto, Toronto, Canada; Division of General Surgery, Mount Sinai Hospital, Toronto, Canada; Institute of Medical Science, University of Toronto, Canada. Electronic address: Carol.Swallow@sinaihealth.ca.
Eur J Surg Oncol ; 47(9): 2390-2397, 2021 09.
Article en En | MEDLINE | ID: mdl-34034943
INTRODUCTION: Resection for isolated distant recurrence of colon cancer is well accepted. Resection for locoregionally recurrent colon cancer (LRCC) is not well studied. We evaluated the long-term outcomes of curative-intent resection for LRCC. METHODS: All patients undergoing curative-intent resection for LRCC at three specialized cancer centers affiliated with the University of Toronto were identified (1993-2017). Follow-up included serial clinical assessment, colonoscopy, CEA, and cross-sectional imaging. Overall survival (OS), cancer-specific survival (CSS) and time to re-recurrence were estimated using Kaplan-Meier method and cumulative incidence function. The association between resection margins and outcome was assessed with Cox models. RESULTS: 117 patients were included in the study cohort. Median follow-up was 53 months (IQR: 34-101). OS was 75% (95% CI: 68-84) at 5 years, and 69% (95% CI: 59-79) at 10 years. CSS was 78% (95% CI: 70-86) at 5 years and 72% (95% CI: 63-83) at 10 years. The rate of re-recurrence was 22% (95% CI: 14-31) at 5 years, and 27% (95% CI: 16-39) at 10 years. Negative resection margin (R0) was associated with improved OS (HR 3.33, 95% CI: 1.85-6.00, p < 0.01). There were no postoperative deaths; complications with Clavien-Dindo grade > II occurred in 12% of patients. Perioperative chemotherapy was used in 63% of patients and radiotherapy in 37%. CONCLUSION: In selected patients with LRCC, excellent OS, CSS and low re-recurrence rates were observed, and R0 resection predicted better outcomes. These findings support consideration of resection for LRCC in fit patients after review at a multidisciplinary cancer conference.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Adenocarcinoma / Neoplasias del Colon / Recurrencia Local de Neoplasia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Adenocarcinoma / Neoplasias del Colon / Recurrencia Local de Neoplasia Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido