Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum

Abstract

Two hundred and eighty patients with previously untreated large bowel adenocarcinoma were retrospectively evaluated following complete primary resection to determine patterns of recurrence. One hundred and five patients (37%) subsequently developed recurrent disease. Sixty percent (63/105) presented with local recurrence alone, 14% (15/105) with concomitant local recurrence and distant metastases, and 26% (27/105) with distant metastases alone. Ninety-two percent of local recurrences developed in structures contiguous to the operative area of the incision. The degree of tumor anaplasia and depth of tumor penetration into the bowel wall influenced the rate of local recurrence. Through 5 years, local recurrence without clinical evidence of distant metastases was the most common cause of death. Plans for adjuvant radiation therapy are discussed.

Revised TN Categorization for Colon Cancer Based on National Survival Outcomes Data

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] In the sixth edition of the AJCC Cancer Staging Manual, stage II was subdivided into IIA (T3N0) and IIB (T4N0), and stage III was subdivided into IIIA (T1-2N1M0), IIIB (T3-4N1M0), and IIIC (any TN2M0), based on improved outcomes for patients with IIA versus IIB disease and for those with IIIA versus IIIB disease. 15,25,26 The placement of all TN2 patients into IIIC, however, was not based on in-depth outcomes analyses, since the impact of depth of bowel wall invasion (T category) in N2 patients had not been evaluated in detail.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] Through the fifth edition of the AJCC (American Joint Committee on Cancer) Cancer Staging Manual, however, substaging was not used to account for marked differences in survival by TN category for patients with stages II and III disease.…”

Beyond foreign‐body‐induced carcinogenesis: Impact of reactive oxygen species derived from inflammatory cells in tumorigenic conversion and tumor progression

“…Most of the clinical local recurrences of gastrointestinal tumors after resection of the primary tumor occur at the operated area of incision or anastomosis. 57,58 Whether fibrosis is accompanied with tumor or not depends on the types of collagen it produces. 59 Tumor-associated fibrosis is characterized by increased collagen Type III content; such fibrotic lesions are mostly in the early immature stage.…”

Substance P increases in vitro lymphokine-activated-killer (LAK) cell cytotoxicity against fresh colorectal cancer cells

“…1 Cass evaluated 165 patients with locally recurrent cancer. 4 Sixty-three had local recurrence al one, 15 had distant metastasls to the liver and 92% of the local recurrences developed in contiguous structure of the original tumor. Any [orm of treatment lhal is addressing local control is therefore very valuable.…”