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Transverse colon cancer as an independent predictor of locoregional recurrence in patients with stage III colon cancer: a retrospective cohort study

Year: 2026

Type: article

Abstract: PURPOSE: This study aimed to evaluate the significance of transverse colon cancer as a predictor of locoregional recurrence in patients with stage III colon cancer. METHODS: This single-center retrospective cohort study included 1,302 patients who underwent curative-intent laparoscopic colectomy for stage III colon cancer between 2003 and 2021. The primary outcome was locoregional recurrence, defined as tumor recurrence near the anastomotic site, regional lymph nodes, or peritoneal recurrence around the primary tumor. Multivariate analyses were conducted to identify the factors associated with locoregional recurrence. RESULTS: Transverse colon cancer was identified in 151 patients (11.6%). Baseline characteristics were similar, but transverse colon cancer exhibited a higher locoregional recurrence rate than nontransverse colon cancer (7.9% vs. 2.0%, P<0.001). In transverse colon cancer, locoregional recurrence did not differ according to high ligation of the mid-colic vessel (without high ligation, 10.6% vs. high ligation, 6.7%; P=0.517), and 10 of 12 recurrences (83.3%) occurred predominantly in the regional lymph nodes. In multivariate analysis, transverse colon (hazard ratio [HR], 4.513; 95% confidence interval [CI], 2.226-9.154; P<0.001) and N2 category (HR, 2.044; 95% CI, 1.034-4.042; P=0.040) emerged as independent predictors of locoregional recurrence. Disease-free survival (73.8% vs. 79.2%, P=0.217) and overall survival (84.7% vs. 86.3%, P=0.735) in 5 years were not different between transverse and nontransverse colon cancer. CONCLUSION: Transverse colon cancer may serve as an independent predictor of locoregional recurrence in stage III colon cancer. The predominance of regional lymph node recurrence emphasizes the importance of careful regional lymph node assessment in transverse colon cancer.

Source: Annals of Coloproctology

DOI: 10.3393/ac.2026.00325.0046