Prognostic factors in local recurrences of colo-rectal tumours

Purpose: The aim of this study was to evaluate, in a group of patients suffering of colo-rectal cancer, the influence on local recurrence of some clinical and anatomo-pathological variables. Methods: The study was limited to 833 patients who underwent potentially curative resection and have been followed for at least two years. All patients were evaluated every six months for the first three years and yearly thereafter by means of clinical, laboratory, endoscopic and radiological investigations. Recurrence was observed in 78 patients (9.4%); 19 of these had evidence of distal failure simultaneously (2.2%). The incidence was 2.4% and 17.7% in the carcinoma of the colon and rectum respectively. Median time of recurrence was 16±11 months; 75% presents within 23 months from operation. Chi-square test was used to relate incidence of recurrence to clinical and anatomo-pathological factors and then a multivariate logistic regression analysis was used to evaluate the most significant variables. Results: Univariate analysis reveals a significant relationship between recurrence and age under 50 years (p=0.01), presence of preoperative complication (p=0.01), stage (p=0.01), site (p=0.000) of primary tumor and lymph-nodal involvement (p=0.0002). No statistically significant difference was found between recurrence and tumor wall infiltration, number of lymphnodes involved, grading and morphology of primary tumor. Multivariate logistic regression analysis confirmed these results except for preoperative complication (p=0.9). Conclusions: Authors believe that selection of patients to undergo adjuvant therapies is improved by identification of high-risk patients.