Abstract
This analysis was aimed at evaluating predictive factors of the time of relapse and prognostic factors in patients with recurrent stage II of III coloreatal cancer after curative resection. Clinicopathological factors selected in this analysis were lymph node metastasis, pathological stage, venous invasion, lymph vessel invasion and histological type, and the duration between initial operation and relapse was observed. Between January 1991 and December 1996, a series of 470 patients were performed curative resection for colorectal cancer and 96 patients of them experienced recurrence. These 96 patients were subjected to the analysis. Median relapse time was 17.7 months after initial resection. Liver metastasis, local recurrence or lung metastasis within two years was noted in 68.9%, 58.8% or 25.0% of them, respectivly. Univariate analysis showed that initial histological type except for well differentiated adenocarcinoma, lymph node metastasis, relapse within 18 months after initial operation, stage III, and aggressive lymph vessel invasion predicted poor prognosis. Multivariate analysis showed that aggressive lymph vessel invasion only predicted poor prognosis. In conclusion, particular attention must be paid to liver metastasis and local recurrence within 2 years after initial operation, and, if the relapse or metastasis occurs, to evaluate the degree of lymph vessel invasion may predict the prognosis and effects of treatments. Aggressive treatments including surgical operation might result in favorable outcomes for relapsed tumors with less degree of lymphatic invasion.
