Predicting Recurrence and Metastasis in Stage III Colorectal Cancer After Laparoscopic Surgery and Laparotomy

Abstract

Introduction: Colorectal cancer remains a significant health challenge, particularly in its advanced Stage III. Timely forecasting of recurrence and metastasis in these patients is crucial for optimizing postoperative care and treatment strategies. The aim of this study is to predict the likelihood of recurrence and metastasis in stage III colorectal cancer patients who have undergone laparoscopic surgery and laparotomy.

Material and Methods: In this retrospective analysis, a total of 528 patients with Stage III colorectal cancer were included. Among them, 386 underwent laparoscopy, and 142 underwent laparotomies. logistic regression was employed to assess the influence of the surgical approach on the binary outcomes of recurrence and metastasis. The data were analyzed using SPSS 25, and Odds Ratios along with significance testing were performed with a threshold of p < 0.05 to determine statistical significance.

Results: In the laparoscopy group, the recurrence rate was 23.7%, and although older patients (61-98 years) exhibited a higher risk of recurrence (Odds Ratio:1.88, 95% CI:0.92-3.84, p=0.083), this difference did not reach statistical significance. Gender did not significantly impact recurrence. In the laparotomy group, the recurrence rate was 29.6%, and neither age nor gender had a significant influence on recurrence. Notably, in the laparoscopy group, metastasis was significantly associated with age (Odds Ratio:5.044, 95% CI:2.08-12.23, p=0.001), while gender did not play a significant role in metastasis. Similarly, in the laparotomy group, neither age nor gender significantly affected metastasis.

Conclusion: This study underscores age's influence on recurrence and metastasis rates in laparoscopic treatment for stage III colorectal cancer, highlighting the need for tailored approaches in elderly patients. In contrast, laparotomy seems to be less affected by age, with tumor size emerging as a crucial predictor of disease progression. Surgical approach significantly impacts outcomes in stage III colorectal cancer, with age affecting laparoscopy outcomes more than laparotomy. These findings emphasize the importance of personalized treatments and call for further research to validate results and enhance patient outcomes in advanced colorectal cancer.