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A refined prediction of early recurrence combining tumor deposits in patients with resected rectal mucinous adenocarcinoma

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Abstract

Purpose

Early recurrence (ER) of rectal mucinous adenocarcinoma (MAC) has yet to be defined. We therefore explored risk factors for ER and constructed a predictive nomogram.

Method

A total of 145 rectal MAC patients undergoing radical surgery were included. The minimum P value method was used to determine the optimal cut-off point to discriminate between ER and late recurrence (LR). Risk factors for ER were determined by a logistic regression analysis, and a predictive nomogram was constructed.

Results

A total of 62 (42.8%) patients developed tumor recurrence. The optimal time to define ER was 12 months. A pre-treatment tumor distance from the anal verge ≤ 7 cm, pathological N stage, lymphovascular invasion, tumor deposits, and time to recurrence ≤ 12 months were significantly associated with a poor post-recurrence survival in patients with recurrence. A pre-treatment serum carcinoembryonic antigen (CEA) level > 10 ng/ml, pre-treatment tumor distance from the anal verge ≤ 7 cm, pathological N + stage, perineural invasion, and tumor deposits were identified as independent risk factors associated with ER. A nomogram predicting ER was constructed (C-index 0.870).

Conclusion

The pre-treatment serum CEA level, pre-treatment tumor distance from the anal verge, pathological N + stage, perineural invasion, and tumor deposits were significantly predictive of ER for rectal MAC patients.

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Data availability

Data not available due to ethical/legal restrictions.

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Acknowledgements

The authors thank all the staff in the Department of colorectal surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, PR China.

Funding

This study was supported by the Construction Project of Fujian Province Minimally Invasive Medical Center ([2017]171), Joint Funds for the Innovation of Science and Technology, Fujian province (2018Y9030, 2019Y9101, 2019Y9061), Young and Middle-aged Backbone Training Project in the Health System of Fujian province (2019-ZQN-45), Natural Science Foundation of Fujian Province (2020J011030), and Medical Science Research Foundation of Beijing Medical and Health Foundation (B20062DS), Fujian provincial health technology project (2020CXA025), and Bethune Charitable Foundation (X-J-2018–004).

Author information

Author notes

  1. Yanwu Sun, Yu Deng, Meifang Xu, Jingming Zhong have contributed equally to this work.

Authors and Affiliations

  1. Department of Colorectal Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China

    Yanwu Sun, Yu Deng, Jingming Zhong, Huiming Lin, Weizhong Jiang, Ying Huang & Pan Chi

  2. Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China

    Meifang Xu

  3. Department of Radiotherapy, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China

    Jianyuan Song

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  1. Yanwu Sun
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Contributions

Yanwu Sun, Yu Deng, and Pan Chi designed the study. Yanwu Sun, Yu Deng, Meifang Xu, and Jingming Zhong collected the data and were major contributors to writing the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ying Huang or Pan Chi.

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Sun, Y., Deng, Y., Xu, M. et al. A refined prediction of early recurrence combining tumor deposits in patients with resected rectal mucinous adenocarcinoma. Surg Today 53, 762–772 (2023). https://doi.org/10.1007/s00595-022-02613-5

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