Postoperative locoregional recurrence pattern and treatment management of stage pT4 sigmoid colon cancer: a retrospective cohort study

Abstract

Background This study aimed to explore the pattern of locoregional recurrence after surgery in patients with non-metastatic stage pT4 sigmoid colon cancer and the role of adjuvant radiotherapy on survival. Methods We retrospectively analyzed data from 208 patients who underwent surgery in our hospital. The patients were randomly divided into training and validation groups at a 1:1 ratio. Patients at high risk for locoregional recurrence were screened using Cox regression analysis. Based on the data of 2,886 patients in the Surveillance, Epidemiology, and End Results (SEER) database, the effect of adjuvant radiotherapy on overall survival (OS) and cancer-specific survival (CSS) was evaluated by Kaplan–Meier curves. Results Of the 208 patients, 57 (27.4%) presented with locoregional recurrences (14 anastomotic and 43 abdominal or pelvic lymph node recurrences). Multivariate analysis showed that serum CEA, differentiation, lymph node dissection number, and N stage were independent predictors of locoregional recurrence-free survival (all p < 0.05). A risk-stratification model was constructed, and a total score of ≥ 6.5 points was considered the high-risk group for locoregional recurrence. Both the training and validation sets presented that the model had a good predictive ability (area under the curve = 0.828 and 0.724, respectively). Analysis of SEER data revealed that adjuvant radiotherapy significantly prolonged OS and CSS in the high-risk population (all p < 0.05, vs. no radiotherapy). Conclusions Patients with a total risk score of 6.5 or more had a high likelihood of locoregional recurrence, and perhaps adjuvant radiotherapy could improve their survival.

The Prognostic and Predictive Significance of Perineural Invasion in Stage I to III Colon Cancer: A Propensity Score Matching-Based Analysis

“…Existing data previously identi ed various prognostic variables in uencing disease recurrence in colorectal cancer patients undergoing curative resection [15][16][17]. PNI has been linked to higher recurrence rates in stage I-III colorectal cancer patients treated with curative intent, according to a study by Holt et al [15].…”

Study protocol of short-course radiotherapy combined with CAPOX and PD-1 inhibitor for locally advanced colon cancer: a randomised, prospective, multicentre, phase II trial (TORCH-C)

“…Radiotherapy (RT) is not widely used in CC, because of the uncertain position and small bowel toxicity, but may be considered in certain clinical scenarios. Patients with stage T4 disease had a high likelihood of locoregional recurrence,5 and perhaps locoregional RT could reduce the recurrence. A small sampled study had shown that patients with pT4b disease receiving adjuvant chemoradiotherapy enhanced locoregional control and DFS 6.…”

Sustained and Localized Drug Depot Release Using Radiation‐Activated Scintillating Nanoparticles

“…Achieving durable locoregional control remains a major challenge across several cancers. [1][2][3][4][5] Many patients have comorbidities or tumor characteristics that preclude surgical resection, and those that do undergo resection can suffer from recurrence. These factors motivate multimodal therapy using systemic chemotherapy, radiation therapy, or a combination of both (Chemoradiation therapy, CRT).…”