Despite curative surgery for colorectal cancer, some patients experience tumor recurrence. Whether early recurrence is associated with a shorter postrecurrence survival period compared with late recurrence remains unknown.
A total of 395 patients with tumor recurrence after curative surgery for colorectal cancer were enrolled and divided into early (<3 years) and late (≥3 years) recurrence groups. Clinicopathologic characteristics, recurrence patterns, and postrecurrence survival were compared.
For stage I and II colorectal cancer, patients with T4 lesions tended to experience early recurrence. For stage III colorectal cancer, early recurrence was more common in patients with N2 disease. Patients with older age, mucinous-type tumors, poorly differentiated histology, the presence of lymphovascular invasion, or multiple site recurrence tended to die <2 years after recurrence. Median postrecurrence survival was similar for the 2 groups. Patients undergoing resection of liver or lung metastases demonstrated longer postrecurrence survival compared with those who did not undergo resection.
Compared with late recurrence, early recurrence does not indicate a worse outcome in colorectal cancer.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Patterns of recurrence after curative resection of carcinoma of the colon and rectum.Surg Gynecol Obstet. 1992; 174: 27-32
- Incidence and patterns of recurrence following curative resection for colorectal carcinoma.Dis Colon Rectum. 1997; 40: 15-24
- Analysis of recurrence patterns following curative resection for carcinoma of the colon and rectum.Surg Gynecol Obstet. 1981; 152: 131-136
- Value of postoperative surveillance after radical surgery for colorectal cancer: results of a cohort study.Dis Colon Rectum. 1998; 41: 714-723
- ESMO Minimum Clinical Recommendations for diagnosis, adjuvant treatment and follow-up of colon cancer.Ann Oncol. 2001; 12: 1053-1054
- Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline.J Clin Oncol. 2005; 23: 8512-8519
- ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of rectal cancer.Ann Oncol. 2003; 14: 1006-1007
- Follow-up of patients with curatively resected colorectal cancer: a practice guideline.BMC cancer. 2003; 3: 26
- Clinical and pathologic evaluation of patients with recurrence of colorectal cancer five or more years after curative resection.Dis Colon Rectum. 2007; 50: 1204-1210
- Clinical and pathological evaluation of patients with early and late recurrence of colorectal cancer.Asia-Pacific J Clin Oncol. 2010; 6: 35-41
- TNM classification of malignant tumors, fifth edition (1997). Union Internationale Contre le Cancer and the American Joint Committee on Cancer.Cancer. 1997; 80: 1803-1804
- Pre-operative chemoradiotherapy with oral tegafur-uracil and leucovorin for rectal cancer.J Surg Oncol. 2005; 89: 256-263
- Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer.N Engl J Med. 2004; 350: 2343-2351
- Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial.J Clin Oncol. 2009; 27: 3109-3116
- Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial.Lancet. 2000; 355: 1041-1047
- Recurrence patterns after curative resection of colorectal cancer in patients followed for a minimum of ten years.Hepatogastroenterology. 2003; 50: 1362-1366
- Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma.N Engl J Med. 1990; 322: 352-358
- The benefit of leucovorin-modulated fluorouracil as postoperative adjuvant therapy for primary colon cancer: results from National Surgical Adjuvant Breast and Bowel Project protocol C-03.J Clin Oncol. 1993; 11: 1879-1887
Published online: November 12, 2013
Received in revised form: July 23, 2013
Received: June 18, 2013
This study was supported by research grants from the National Science Council (101-2314-B-075-023) and the Department of Medical Research & Education, Taipei Veterans General Hospital (V101B-006 and V102B-012).
The authors declare no conflicts of interest.
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.