Risk factors for recurrence in stage II/III colorectal cancer patients treated with curative surgery: The impact of postoperative tumor markers and an infiltrative growth pattern

Kazuaki Tokodai, Hiroto Narimatsu, Akiko Nishida, Kai Takaya, Yasuyuki Hara, Naoki Kawagishi, Eiji Hashizume, Noriaki Ohuchi

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background and Objectives: We evaluated the capacity of clinicopathological factors to predict recurrence in stage II/III colorectal cancer (CRC) patients after curative resection. Methods: We retrospectively examined 386 stage II/III CRC patients who underwent curative resections between April 2008 and August 2013. We assessed the predictive power of pre- and postoperative tumor marker levels, lymphatic and venous invasion, and infiltrative growth patterns using Cox's proportional hazards model. Results: Of 206 stage II and 180 stage III patients, 26 (13%) and 46 (26%) patients, respectively, developed recurrences with median follow-up times of 51 and 45 months, respectively. Independent risk factors for recurrence were lymphatic invasion (hazard ratio [HR], 5.99; P = 0.0006) and infiltrative growth patterns (HR, 4.02; P = 0.017) in stage II patients; and elevated preoperative carcinoembryonic antigen levels (HR, 3.22; P = 0.004), elevated postoperative carbohydrate antigen 19–9 levels (HR, 5.08; P = 0.005), and infiltrative growth patterns (HR, 3.19; P = 0.037) in stage III patients. Conclusions: High-recurrence risk can be identified in stage II/III CRC patients by assessing perioperative serum tumor marker levels, lymphatic invasion, and infiltrative growth patterns. Intensive follow-up for patients with these risk factors may help detect recurrences promptly and improve survival. J. Surg. Oncol. 2016;114:368–374.

Original languageEnglish
Pages (from-to)368-374
Number of pages7
JournalJournal of Surgical Oncology
Volume114
Issue number3
DOIs
Publication statusPublished - 2016 Sep 1

Keywords

  • carbohydrate antigen 19-9
  • carcinoembryonic antigen
  • colorectal cancer
  • infiltrative growth pattern
  • lymphatic invasion
  • risk stratification

ASJC Scopus subject areas

  • Surgery
  • Oncology

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