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Session: ePoster: Colon and Colorectal Cancer 7 (Sun350)

EP553 - Survival Analysis Based on Recurrence Sites in Colon Cancer Patients Following Radical Surgery

Sunday, May 11, 2025
4:33 PM – 4:38 PM PT
Location: Monitor 2, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Yih Jong Chern

    attending physician
    chang gung memorial hospital
    Guishan District, Taoyuan, Taiwan (Republic of China)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Hsin-Yin Hsu, MD, MS (she/her/hers)

    Attending physician
    Department of Family Medicine, Taipei MacKay Memorial Hospital
    Taipei, Taipei, Taiwan (Republic of China)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • YH

    Yu-Jen Hsu, n/a

    Doctor
    Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital
    Kuei-Shan, Taoyuan, Taiwan (Republic of China)

    Disclosure information not submitted.

  • YY

    Yen-Lin Yu, n/a

    Doctor
    Division of Colon and rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung branch
    Keelung, Keelung, Taiwan (Republic of China)

    Disclosure information not submitted.

    • Senior Author(s)

  • JY

    Jeng-Fu You, n/a

    Attending physician
    Chang Gung Memorial Hospital
    Taoyuan, Taoyuan, Taiwan (Republic of China)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Yih Jong Chern: This individual has no financial relationships with ineligible companies.
Hsin-Yin Hsu, MD, MS: This individual has no financial relationships with ineligible companies.
Jeng-Fu You, n/a: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: In colon cancer, the initial pathological tumor (pT) and lymph node (pN) stages are crucial indicators of the risk of distant metastasis. For colon cancer patients who received radical resections then recurrence occurred, the prognosis varies significantly depending on the metastatic site. The aim of our study was to integrate information on TN stage and metastasis patterns to analyze the long-term outcome.

Methods/Interventions: This retrospective study utilizing data from the Colorectal Section Tumor Registry at Chang Gung Memorial Hospital consisted of patients with primary colon adenocarcinoma who underwent radical resection between January 2006 and December 2018. In this study, patients were categorized into four groups based on their tumor-node (T/N) stage at the time of diagnosis. A multinomial logistic regression model was then employed to investigate the association between different T stages and nodal invasion statuses with various metastatic outcomes in colon cancer patients. We also applied a marginal structural model to evaluate how the controversial oncological prognoses associated with T1-3 with nodal invasion and T4 without nodal invasion stages, as well as the presence of isolated lung metastasis, impact overall survival.

Results/Outcomes: Of the 7259 non-metastasis colon cancer patients who underwent curative resection, the study categorized them into four groups based on the tumor-node (T/N) stage: T1-3 tumors without nodal invasion (n=3273), T1-3 tumors with nodal invasion (n=1779), T4 tumors without nodal invasion (n=1038), and T4 tumors with nodal invasion (n=1169).
In patients with nodal invasion (N+), those with T1-3 stage compared with T4 stage show a reduced risk of developing focal site metastasis (OR: 0.61, 95% CI: 0.40-0.93). Patients with T4 stage disease without nodal invasion were at a much greater risk of focal recurrence (OR: 3.77, 95% CI: 3.74-3.79) and are less likely to develop isolated lung (OR: 0.73, 95% CI: 0.72-0.74) or liver metastasis (OR: 0.91, 95% CI: 0.90-0.91) when compared with those with T1-3 stage and nodal invasion.
For the recurrent colon patients, the result using marginal structural model exploring the relationship between TN stage (T1-3 with nodal invasion vs. T4 without nodal invasion), the presence of isolated lung metastasis, and the associated risk of death demonstrated that patients with T1-3 and nodal invasion and isolated lung metastasis have a significantly reduced risk of death ( 0.63, 95% CI: 0.51-0.78)
For patients who developed lung metastasis, the survival rate after operation and after recurrence were both higher than patients who have focal, liver or multiple sites metastasis (60.5% in 5 years after operation, 41.9% in 5 years after first recurrence occurred).

Conclusion/Discussion: We analyzed the relationship between colon cancer pathological stage and the recurrence pattern after radical resection. The T4 patients with or without nodal invasion have a much greater risk of focal recurrence, and are less likely to develop isolated lung or liver metastasis when compared with those with T1-3N+ group. For patients who developed lung metastasis, the survival rate after operation and after recurrence were both higher than patients who have focal, liver or multiple sites metastasis. In T4 patients, surveillance after radical resection need more delicate action to detect intra-abdominal recurrence.