The Prognosis of Early Recurrence in Patients with Colorectalcancer and Risk Factors for Early Recurrence

Risk Factors for Early Recurrence in Colorectal Cancer

Abstract

Background: Because predicting recurrence intervals and patterns would allow for appropriate therapeutic strategies, we evaluated the clinical and pathological characteristics of early recurrence of colorectal cancer and the survival in the recurrence patients. Methods: Patients who developed recurrence after undergoing curative resection for colorectal cancer stage IIII between July 2017 to june 2020 were identified. Analyses were performed to compare the clinicopathological characteristics in the recurrence patients followed by detecting the overall prognosis. Subjects and Methods: Four patients had cancer recurrence of consecutive 48 patients who underwent surgical resection for colorectal cancer from 2017 to 2018. Patients who underwent curative resection were enrolled in this study. The mean follow-up period of the patients was 26+-7 months. Among 4 patients with early relapse, All four were advanced T-stage, 03 (75%) had elevated postoperative CEA and 03 (50%) had venous invasion. T-Stage, postoperative CEA levels and venous Invasion were statistically significant. Among four recurrence patients, three (75%) recurrences were within 9 months. Among these patients, metastasis alone within the liver was one patient (25%), metastasis to peritoneum and liver was one patient (25%), and local recurrence in two patients (50%) respectively. The initial diagnosis of patients with early recurrence was done by CEA tumor marker as it rose (75%) and clinical parameters. Definite diagnosis was done by CT, and by alternative methods like PET-CT. two patients underwent surgery for recurrent lesions, two patients received chemotherapy only. In the follow up period two patients with distant metastasis died and one patient with Low anterior resection who had recurrence was followed by chemoradiation and APR. Result: In this study, only four (04) patients (8.3%), including two (02)with colon cancer (6.6%) and two (02)with rectal cancer (11.1%) had post operative recurrence within the time period . Among four patients with post operative recurrence, All patients were advanced T - Stage, three(75%) had elevated post operative CEA levels and three (50%) had venous invasion. We found no differences in the factors like sex, age, primary tumor site, operative method, tumor size, type of histopathology, the degree of lymphatic or neural invasion,preoperative CEA levels in the patients with recurrence. Conclusion: patients with high postoperative CEA levels, advanced T-Stage and venous Invasion after surgery should be examined by the abdominal CT scan or as early as possible after surgery as the prognosis of these patients is not good.