Background: Locoregional recurrence rates after curative resection for colon cancer vary widely. Identification of factors associated with locoregional recurrence may help in patient management.
Objective: The purpose of this study was to compare time to locoregional recurrence and distribution of locoregional recurrence after curative resection of colon cancer according to primary tumor location and to investigate risk factors for locoregional recurrence of colon cancer.
Design: This was a retrospective observational study.
Settings: This study was conducted at a single institution.
Patients: This study analyzed 1632 patients with colonic adenocarcinoma without distant metastasis who underwent curative resection at the National Cancer Center in Korea between January 2001 and December 2009. The primary end point of the study was time from surgery to locoregional recurrence. The Kaplan-Meier method was used to estimate the cumulative incidence of locoregional recurrence, and the log-rank test was used to test the difference in time to locoregional recurrence between patient subgroups. Cox proportional hazards models were used to investigate the risk factors for locoregional recurrence.
Main outcome measures: The time from surgery to locoregional recurrence was compared between patients with right-sided and left-sided colon cancers.
Results: The time to locoregional recurrence was significantly different between patients with right-sided and left-sided colon cancers (HR = 2.35 for right-sided; p < 0.001). The overall 5-year locoregional recurrence rate was 5.7%, and that in patients with right-sided and left-sided colon cancers was 8.5% and 4.1%. Multivariable analysis demonstrated that right-sided location, female sex, T4 disease, lymph node metastasis, and perineural invasion were independent risk factors for locoregional recurrence of colon cancer.
Limitations: This was a retrospective design and single-institution study.
Conclusions: Patients with right-sided colon cancers presented with significantly increased risk of locoregional recurrence. Right-sided location, female sex, T4 disease, lymph node metastasis, and perineural invasion are independent risk factors for locoregional recurrence of colon cancer.