Differences between colon and rectal cancer in complications, short-term survival and recurrences

Abstract

PurposeMany apparent differences exist in aetiology, genetics, anatomy and treatment response between colon cancer (CC) and rectal cancer (RC). This study examines the differences in patient characteristics, prevalence of complications and their effect on short-term survival, long-term survival and the rate of recurrence between RC and CC.MethodsFor all stage II–III CC and RC patients who underwent resection with curative intent (2006–2008) in five hospitals in the Netherlands, occurrence of complications, crude survival, relative survival and recurrence rates were compared.ResultsA total of 767 CC and 272 RC patients underwent resection. Significant differences were found for age, gender, emergency surgery, T-stage and grade. CC patients experienced fewer complications compared to RC (p = 0.019), but CC patients had worse short-term mortality rates (1.5 versus 6.7 % for 30-day mortality, p = 0.001 and 5.2 versus 9.5 % for 90-day mortality, p = 0.032). The adjusted HR (overall survival) for CC patients with complications was 1.57 (1.23–2.01; p < 0.001) as compared to patients without complications; for RC, the HR was 1.79 (1.12–2.87; p = 0.015). Relative survival analyses showed high excess mortality in the first months after surgery and a sustained, prolonged negative effect on both CC and RC. Complications were associated with a higher recurrence rate for both CC and RC; adjusted analyses showed a trend towards a significant association.ConclusionLarge differences exist in patient characteristics and clinical outcomes between CC and RC. CC patients have a significantly higher short-term mortality compared to RC patients due to a more severe effect of complications.

Clinical Predictors for Recurrence after Curative Resection for Colorectal Cancer

“…We did not find any significant overall difference in recurrence rates between colon and rectal cancers, which is in contrast to a pervious Dutch study [9].…”

“…Previous studies have identified several possible additional factors associated with recurrence. Patient factors, like intake of coffee and alcohol, smoking, weight-loss and Glascow Prognostic score [2] [3] [4] [5] [6], treatment factors like surgical experience and technique [7] [8], tumor factors like location, differentiation, vein-, nerve-and lymphatic ingrowth [9] [10] and molecular factors [11] [12] [13] [14] have been shown to influence cancer recurrence, and adjuvant oncological therapy is often recommended. In the present study, we have taken interest in what consequences repeated or aggravated inflammatory stress will inflict on the patient and influence the risk of recurrence after potential curative resection of colorectal cancer.…”

Risk factors for surgical site infections in rectal cancer patients

“…As such, it therefore seems appropriate to analyse treatment outcomes separately. Many studies have found that SSI occurs more frequently in rectal cancer patients undergoing surgery than in those being operated for colonic cancer [11][12][13][14]17]. A study by Konishi et al on 556 patients after large bowel resection found that in those post-rectal resection, SSI occurred twice more frequently compared to patients who had undergone colonic resection, (i.e.…”

Circulating and genetic factors in colorectal cancer: Potential factors for establishing prognosis?

“…This study showed a lower survival among colon cancer patients because of a more severe effect of complications compared with patients with rectal cancer (van der Sijp et al, 2016).…”

“…Several studies have shown genetic, morphological, and clinical differences, as well as differences in survival between cancers of the colon and rectum (Kornmann et al, 2013, van der Sijp et al, 2016 suggesting that CRC might consist of two separate entities. As an example Kornmann et al showed an improved survival in treated patients with colon cancer but not among patients with rectum…”