The survival after recurrence of colorectal cancer: a retrospective study focused on time to recurrence after curative resection

• Published in: Surgery today (Tokyo, Japan) Japan), 2022-02, Vol.52 (2), p.239-250
• Main Authors: Furuke, Hirotaka, Arita, Tomohiro, Kuriu, Yoshiaki, Shimizu, Hiroki, Kiuchi, Jun, Yamamoto, Yusuke, Konishi, Hirotaka, Morimura, Ryo, Shiozaki, Atsushi, Ikoma, Hisashi, Kubota, Takeshi, Nakanishi, Masayoshi, Fujiwara, Hitoshi, Okamoto, Kazuma, Otsuji, Eigo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Chemotherapy, Adjuvant; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Digestive System Surgical Procedures - methods; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - prevention & control; Neoplasm Staging; Original Article; Retrospective Studies; Surgery; Surgical Oncology; Time Factors; Young Adult
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-021-02336-z

Purpose The significance of the duration of the recurrence-free survival after curative resection for colorectal cancer remains unclear. The purpose was to reveal the association between time to recurrence after surgery and the survival after recurrence. Methods Patients with stage II and III colorectal cancer who underwent curative resection between 2007 and 2015 were retrospectively reviewed ( n  = 645). Patients with recurrence after surgery ( n  = 133) were divided into 2 groups: early recurrence (within 13 months after surgery, n  = 63) and late recurrence (more than 13 months after surgery, n  = 70). The overall survival after recurrence and clinicopathological features were compared between early recurrence, late recurrence, and without recurrence groups. Results The overall survival after recurrence was significantly shorter in patients with early recurrence occurring at less than 13 months (hazard ratio: 1.70, p  = 0.03). A high preoperative CA19-9 level (odds ratio [OR]: 2.38, p  = 0.03), venous invasion (OR: 2.26, p  = 0.03), and the absence of adjuvant chemotherapy (OR: 2.08, p  = 0.04) were independently correlated with early recurrence. Conclusion Early recurrence was associated with a poor prognosis after recurrence. Venous invasion correlated with early recurrence. Adjuvant chemotherapy may reduce the risk of early recurrence. These results indicate the importance of prudent surveillance and the aggressive application of adjuvant chemotherapy.