Risk of Recurrence Following Curative Colon Cancer Surgery: A Single Institution Experience

Although resection is the standard curative treatment in the United States for nonmetastatic colon cancer, postoperative recurrence remains a major concern. The incidence, risk factors, and outcomes of postoperative recurrence have primarily been derived from clinical trials, which may differ significantly from the 'real-world' experience. Therefore, the primary aim of this study is to determine the incidence and risk factors for postoperative recurrence in nonclinical trial patients undergoing surgical resection for nonmetastatic colon cancer at the University of Chicago Comprehensive Cancer Center (UCCCC).

This retrospective review included patients of ≥18 y old who were diagnosed with nonmetastatic colon adenocarcinoma, were not enrolled in a clinical trial, and underwent resection of their primary tumor between 2015 and 2023 at UCCCC. Demographic and clinical variables were abstracted from the UCCCC registry.

A total of 491 patients were included in the study. The overall recurrence rate was 14.5%, with a median time to recurrence of 10 mo (interquartile range 6-19). Almost all recurrences occurred at distant sites (87.3%). Univariable and multivariable Cox regression analyses showed that a higher overall stage was associated with increased recurrence and decreased survival. The overall recurrence rates were 2% for stage I, 14% for stage II, and 24% for stage III (P < 0.001).

This report documents the incidence and risk factors for postoperative recurrence after attempted curative resection for colon cancer in patients not enrolled in a clinical trial. This data can be used to benchmark quality improvement and to educate patients about their expected prognosis.