[Analysis of risk factors for recurrence after radical resection in colon cancer patients with retroperitoneal lymph node metastasis].

Objective: To investigate the recurrence status and risk factors for recurrence in patients with colon cancer and retroperitoneal lymph node metastasis undergoing radical resection. Methods: This retrospective observational study analyzed clinical data from 303 patients with colon cancer and retroperitoneal lymph node metastasis admitted to Xinxiang Central Hospital between January 2020 and January 2024. The observed indicators were patient recurrence status and the risk factors associated with postoperative recurrence following radical surgery. Results: The median follow-up period was 17 (IQR: 13, 22) months. The 3-year recurrence-free survival rate was 50% (95%CI: 40%-60%). During the follow-up period, 85 patients (28.1%) experienced recurrence, with a median time to recurrence of 12 (IQR: 9, 15) months. Cox univariate and multivariate analyses identified multiple retroperitoneal lymph node metastases (HR=2.123, 95%CI: 1.248-3.611), postoperative complications (HR=1.802, 95%CI: 1.164-2.794), and elevated TNF-α levels (HR=1.127, 95%CI: 1.085-1.171) as independent risk factors for post- operative recurrence. Conversely, D2 or D3 lymph node dissection was identified as a protective factor compared to D1 dissection (HR=0.424, 95%CI: 0.223-0.803). Conclusions: For colon cancer patients with suspected retroperitoneal lymph node metastasis, active implementation of D2 or D3 lymphadenectomy is recommended to reduce the risk of postoperative recurrence, particularly in patients with multiple metastases or elevated preoperative TNF-α levels.