Association of resection margin distance with anastomotic recurrence in stage I-III colon cancer: data from the National Colorectal Cancer Cohort (NCRCC) study in China

Fei Huang ¹, Shan Jiang ¹, Ran Wei ²

⁰Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.

International Journal of Colorectal Disease +

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July 12, 2024

View abstract on PubMed

Summary

Anastomotic recurrence (AR) in colon cancer is linked to distal resection margin distance and advanced N stage. Prognosis for AR is similar to nonanastomotic local recurrence (NAR).

Area Of Science

Surgical Oncology
Gastrointestinal Surgery
Cancer Recurrence

Background

Anastomotic recurrence (AR) is an understudied complication in colon cancer surgery.
Understanding risk factors for AR is crucial for improving patient outcomes.
This study investigates AR in relation to surgical margins and compares its prognosis to nonanastomotic local recurrence (NAR).

Purpose Of The Study

To clarify the association between resection margin distance and anastomotic recurrence (AR) in colon cancer.
To compare the prognosis of patients with AR to those with nonanastomotic local recurrence (NAR).

Main Methods

Retrospective cohort study of 1958 patients undergoing radical colon cancer surgery (2009-2019).
Analysis of clinical data focusing on resection margin distances (proximal and distal).
Multivariate analysis to identify risk factors for AR and comparison of survival outcomes between AR and NAR groups.

Main Results

Anastomotic recurrence (AR) occurred in 1.7% of patients, while nonanastomotic local recurrence (NAR) occurred in 5.4%.
Lower distal resection margin distance, advanced N stage, and fewer dissected lymph nodes were significant risk factors for AR.
AR risk was lowest with proximal margins ≥6 cm and increased significantly with distal margins <3 cm.
Prognosis for AR was comparable to NAR, irrespective of distant metastases.

Conclusions

Distal resection margin distance, advanced N stage, and lymph node dissection count are key factors associated with AR in colon cancer.
The long-term prognosis for patients experiencing anastomotic recurrence is similar to those with nonanastomotic local recurrence.

Keywords:

Anastomotic recurrence Colon cancer Resection margin distance Survival