Predictive factors of recurrence and survival after resection of left colon cancer | ||
| The Egyptian Journal of Surgery | ||
| Article 21, Volume 41, Issue 1, January 2022 PDF (304.2 K) | ||
| DOI: 10.4103/ejs.ejs_303_21 | ||
| Authors | ||
| Helmy Ezzat; Mahmoud Elashry; Tarek Salah; Ahmed Shehta; Ahmed Monier | ||
| Abstract | ||
| Aim To evaluate our center’s experience of resection of left colon cancer and to determine the factors affecting both recurrence and survival after resection of left colon cancer. Patients and methods We reviewed patient’s data who underwent colonic resection for left colon cancer during the period between January 2008 and December 2018. Results A total of 220 patients were included. The median age was 58.5 days (25–83 years). The most common presenting symptoms were weight loss (48.2%) and bleeding per rectum (40.9%). Sigmoidectomy was performed in 117 (53.2%) patients, whereas left hemicolectomy in 101 (45.9%) patients and Hartmann’s procedure in two (0.9%) patients. The median operation time was 3 h (1–5 h), and the median blood loss was 150 ml (50–750 ml). Anastomotic leakage occurred in 13 (5.9%) patients, whereas internal hemorrhage in two (0.9%) patients. Recurrence occurred in 92 (41.8%) patients. The 1-, 3-, and 5-year disease-free survival rates were 98.8, 51.7, and 40.5%, respectively. Mortality occurred in 43 (19.5%) patients. The 1-, 3-, and 5-year overall survival rates were 99.4, 87.7, and 72.3%, respectively. On multivariate analysis, lymphovascular emboli, perineural invasion, and tumor stage were significant predictors for recurrence, whereas serum CA19-9 and tumor stage were significant predictors for survival. Conclusion Identification of high-risk patients for recurrence after resection of colon cancer allows for implementation of intensive follow-up regimens and the use of adjuvant therapy. | ||
| Keywords | ||
| Colon cancer; left hemicolectomy; sigmoidectomy | ||
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