Predictors for local recurrence and distant metastasis of mucinous colorectal adenocarcinoma

Sameh Hany Emile; Alaa Magdy; Waleed Elnahas; Omar Hamdy; Mahmoud Abdelnaby; Wael Khafagy

doi:10.1016/j.surg.2017.11.028

Predictors for local recurrence and distant metastasis of mucinous colorectal adenocarcinoma

Surgery. 2018 Feb 1:S0039-6060(17)30879-6. doi: 10.1016/j.surg.2017.11.028. Online ahead of print.

Authors

Sameh Hany Emile¹, Alaa Magdy², Waleed Elnahas³, Omar Hamdy³, Mahmoud Abdelnaby², Wael Khafagy²

Affiliations

¹ Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura City, Egypt. Electronic address: sameh200@hotmail.com.
² Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, Mansoura City, Egypt.
³ Oncology Centre Mansoura University (OCMU), Mansoura University, Mansoura, Egypt.

PMID: 29361368
DOI: 10.1016/j.surg.2017.11.028

Abstract

Background: Mucinous adenocarcinoma (MA) is a unique subtype of colorectal carcinoma. Although some investigators considered MA a predictor for poor prognosis, predictors for poor clinical outcome of MA were not elucidated. The present study aimed to investigate the predictors for local recurrence and distant metastasis of MA.

Methods: This was a retrospective review of patients with MA who underwent operation with curative intent. Variables included patient and tumor characteristics, TNM stage, investigations, details of surgery, and postoperative outcomes, including local recurrence and distant metastasis. Univariate and multivariate regression analyses were performed to determine the risk factors for local and systemic disease recurrence.

Results: A total of 106 patients (83 male) of a mean age of 51.5 years were included; 62% of patients had colonic tumors, and 38% had rectal tumors; 77% and 58% of colonic and rectal cancers, respectively, were T3-T4 tumors. There were no lymph node metastases in 61% of colonic tumors and 55% of rectal tumors. Local recurrence occurred in 15 patients (14%) and distant metastasis in 9 (9%). Predictors for local recurrence were age (odds ratio [OR]: 1.04; P = .04), female sex (OR: 4.5; P = .01), rectal tumors (OR: 3.73; P = .02), and T4 tumors (OR: 10.9; P = 0.03). Predictors for distant metastasis were age (OR: 1.1; P = .016), local recurrence (OR: 24.28; P < .0001), and T4 tumors (OR: 19.3; P = .049).

Conclusion: Patients' age, female sex, and T4 tumors were significant predictors for local recurrence and distant metastasis. Rectal tumors had a greater likelihood for regional recurrence than colonic tumors. Local recurrence was an independent risk factor for distant metastasis.