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Loco-regional Recurrence from Colon Cancer: A Population-based Study

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Abstract

Background

The survival after colon cancer surgery has not improved to the same extent as after rectal cancer treatment and studies on loco-regional recurrence after colon cancer surgery are scarce. The aim of this study was to assess the problem of loco-regional recurrence after potentially curative resections for colon cancer, regarding incidence, risk factors, management, and outcome.

Methods

All 1,856 patients submitted to potentially curative surgery for colon cancer in the Stockholm/Gotland region in Sweden between 1996 and 2000 were followed until January 2005 or until death. Follow-up data were prospectively collected. Risk factors for loco-regional recurrences were analyzed, treatment and outcome for patients with recurrence was studied.

Results

The cumulative 5-year incidence of loco-regional recurrence was 11.5%. Tumor locations in the right flexure and in the sigmoid colon, bowel perforation and emergent surgery were identified as independent risk factors for loco-regional recurrence. The risk also increased with increasing T- and N-stage.

The median survival for all 192 patients with loco-regional recurrence was 9 months. Surgery was performed in 110 (57%) patients. In 23 (12%) patients a complete tumor clearance was achieved and the estimated 5-year survival in this group was 43%.

Conclusion

Loco-regional recurrence from colon cancer is a significant clinical problem. A multidisciplinary treatment approach, including preoperative staging, a complete resection of the recurrence and more effective adjuvant treatments may improve the outcome.

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Acknowledgements

The present study was supported by the Stockholm Cancer Society. “The Colon Cancer Project in Stockholm” is supported by Tyco Healthcare. The authors thank the Stockholm Colorectal Cancer Study Group who made the registers available for this study and Toom Singnomklao for excellent help with the collection of data.

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Authors and Affiliations

  1. Department of Surgery, P9:03, Karolinska University Hospital, Solna, Department of Molecular Medicine and Surgery, Karolinska Institutet, 17176, Stockholm, Sweden

    Annika Sjövall, Björn Cedermark & Torbjörn Holm

  2. Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden

    Fredrik Granath

  3. Department of Oncology and Pathology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

    Bengt Glimelius

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  1. Annika Sjövall
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  2. Fredrik Granath
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  3. Björn Cedermark
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  4. Bengt Glimelius
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  5. Torbjörn Holm
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Correspondence to Annika Sjövall.

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Sjövall, A., Granath, F., Cedermark, B. et al. Loco-regional Recurrence from Colon Cancer: A Population-based Study. Ann Surg Oncol 14, 432–440 (2007). https://doi.org/10.1245/s10434-006-9243-1

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  • DOI: https://doi.org/10.1245/s10434-006-9243-1

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