RISK-FACTORS OF LOCAL RECURRENCE OF COLORECTAL-CANCER - A MULTIVARIATE STUDY

BACKGROUND/AIMS: Duke's staging is still the most widely used paramete r in the estimation of risk for local recurrence in patients with colo rectal neoplasia. The aim of this study is to identify biological dete rminants that may be of use in segregating patients with similarly sta ged tumors into groups with different risk of local recurrence. METHOD OLOGY: Ninety-eight patients who had undergone curative resection for colorectal cancer between 1989 and 1991 were prospectively studied. St atistical analysis of clinical and pathologic variables was carried ou t using a Cox multivariate proportional hazard model. RESULTS: Dukes s tage and DNA ploidy were the only significantly predictive variables f or local recurrence. In particular, the factors increasing local recur rence risk were seen to be the presence of lymph node metastases and a neuploid status. In the absence of both of these negative prognostic f actors the risk of local recurrence is practically nil, in the presenc e of just one it reaches 16% and in the presence of both it rises to o ver 40%. CONCLUSIONS: The results of this study indicate that the pres ence of an aneuploid tumor with positive lymph nodes places patients a t a higher risk of local recurrence, and calls for post-operative adju vant therapy and intensive follow-up.