AIM To evaluate prognostic pathological factors associated with early metachronous disease and adverse longterm survival in these patients.METHODS Clinical and histological features were analysed retrospectively over ...AIM To evaluate prognostic pathological factors associated with early metachronous disease and adverse longterm survival in these patients.METHODS Clinical and histological features were analysed retrospectively over an eight-year period for prognostic impact on recurrent disease and overall survival in patients undergoing curative resection of a primary colorectal cancer. RESULTS A total of 266 patients underwent curative surgery during the study period. The median age of the study cohort was 68 year(range 26 to 91) with a followup of 7.9 years(range 4.6 to 12.6). Resection was undertaken electively in 225(84.6%) patients and emergency resection in 35(13.2%). Data on timing of surgery was missing in 6 patients. Recurrence was noted in 67(25.2%) during the study period and was predominantly early within 3 years(82.1%) and involved hepatic metastasis in 73.1%. Emergency resection(OR = 3.60, P = 0.001), T4 stage(OR = 4.33, P < 0.001) and lymphovascular invasion(LVI) (OR = 2.37, P = 0.032) were associated with higher risk of recurrent disease. Emergency resection, T4 disease and a high lymph node ratio(LNR) were strong independent predictors of adverse long-term survival. CONCLUSION Emergency surgery is associated with adverse disease free and long-term survival. T4 disease, LVI and LNR provide strong independent predictive value of longterm outcome and can inform surveillance strategies to improve outcomes.展开更多
文摘AIM To evaluate prognostic pathological factors associated with early metachronous disease and adverse longterm survival in these patients.METHODS Clinical and histological features were analysed retrospectively over an eight-year period for prognostic impact on recurrent disease and overall survival in patients undergoing curative resection of a primary colorectal cancer. RESULTS A total of 266 patients underwent curative surgery during the study period. The median age of the study cohort was 68 year(range 26 to 91) with a followup of 7.9 years(range 4.6 to 12.6). Resection was undertaken electively in 225(84.6%) patients and emergency resection in 35(13.2%). Data on timing of surgery was missing in 6 patients. Recurrence was noted in 67(25.2%) during the study period and was predominantly early within 3 years(82.1%) and involved hepatic metastasis in 73.1%. Emergency resection(OR = 3.60, P = 0.001), T4 stage(OR = 4.33, P < 0.001) and lymphovascular invasion(LVI) (OR = 2.37, P = 0.032) were associated with higher risk of recurrent disease. Emergency resection, T4 disease and a high lymph node ratio(LNR) were strong independent predictors of adverse long-term survival. CONCLUSION Emergency surgery is associated with adverse disease free and long-term survival. T4 disease, LVI and LNR provide strong independent predictive value of longterm outcome and can inform surveillance strategies to improve outcomes.
