Dukes A大腸癌術後再発症例の検討

Abstract

Introduction: We evaluated the characterisitics and risk factors for recurrence and optimal follow-up for Dukes A colorectal cancer. Materials and Methods: Between 1965 and 1995, 372 patients were classified with Dukes A colorectal cancer among 2, 435 colorectal cancer patients undergoing surgical resection at our hospital. We evaluated the clinicopathological characteristics of the recurred cases, and those from rectal cancer were compared to the recurrence-free cases with the background factors. We also carried out multivariate analysis with the factors whose p value was under 0.1. Results: Of these, 16 (4.3%) showed recurrence, and 15 of the 16 cases were derived from rectum. Primary recurrence sites from rectal cancer were local (9), lung (4), liver (2) and bone (1). Eleven cases recurred within 2 years, and the rate of local recurrence was 72.7%. On the other hand, five cases recurred between 2 and 5 years, and the rate of far metastasis was 80.0%. Univariate analysis comparing to 194 recurrence-free cases showed histology to be an only significant risk factor for recurrence (p=0.003), and multivariate analysis with 3 factors also showed the identical result (p=0.005). Discussion: It is not so important to do follow-up for Dukes A colon cancer, but in case of Dukes A rectal cancer, we should do follow-up with attention to local recurrence within 2 years and to far metastasis between 2 and 5 years. Since cases whose histology are not differentiated type have very high risk for recurrence, intensive postoperative follow-up is necessary as far advanced cancer.