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Risk factors for recurrence of stage I/II (TNM) colorectal adenocarcinoma in patients undergoing surgery with curative intent

Fatores de risco para recidiva em pacientes com adenocarcinoma colorretal estádio I e II (TNM) submetidos à cirurgia com intenção curativa

OBJECTIVE:

Evaluate risk factors for colorectal cancer recurrence after surgical treatment.

METHODS:

Sixty-five patients with colorectal adenocarcinoma, stage I and II (TNM), undergoing curative-intent surgery and followed for five years were studied. Presence of adjuvant/neoadjuvant therapy, tumor differentiation degree, lymphatic and venous vascular infiltration, depth of tumor invasion, and disease staging was analyzed, using recurrence relative risk ratios for each parameter calculated at two years, after two years and five years of follow up.

RESULTS:

At five years, recurrence was 21.4% (14/65), with equal incidence (10.7%) for the separated periods. Only lymphatic and venous vascular infiltration showed statistically significant association with recurrence during times analyzed. Relative risk (RR) of recurrence was significantly related to the presence of lymphatic infiltration [RR = 6 (1.3 - 28.5) p = 0.01] and venous infiltration [RR = 9.5 (2.6 - 34.9) p < 0.001] after two years of follow-up. At five years follow-up, only venous infiltration remained with significant relative risk for recurrence [RR = 3.9 (1.8 - 8.8) p < 0.001]. In a multivariate analysis, only venous vascular infiltration was associated with recurrence [accuracy 81.5% (p < 0.001)].

CONCLUSION:

In this series, the factors associated with risk of colorectal cancer recurrence were the presence of lymphatic and venous vascular infiltration.

Neoplastic invasiveness; Adenocarcinoma; Prognosis; Colorectal neoplasms


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