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Early recurrence in patients undergoing curative surgery for colorectal cancer: is it a predictor for poor overall survival?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

This study evaluated the prognostic value of early recurrence in patients who have undergone curative resection for colorectal cancer.

Methods

A total of 1,159 consecutive patients who underwent curative resection for non-metastatic colorectal cancer from December 1998 to December 2007 were reviewed. The predictive factors for early recurrence postoperatively and the prognostic factors were analyzed.

Results

Of the 1,159 patients, postoperative recurrence was identified in 280 (24.1 %) patients, and 96 (34.3 %) of the 280 patients with recurrence were designed as early recurrence (less than 1 year postoperatively). In multivariate analysis, tumor location, tumor diameter, number of retrieved lymph nodes, and lymphovascular invasion were the independent predictors for early recurrence. The early recurrence group had a significantly lower overall survival rate than that of the non-early recurrence group for both colon cancer (P < 0.001) and rectal cancer (P < 0.001). The overall survival rate for stage III tumors significantly differed between the early and non-early recurred patients (P < 0.001), whereas the rate did not differ between the patients with stage II tumors (P = 0.364). In multivariate analysis, early recurrence was an independent predictor for unfavorable overall survival. Moreover, differentiation, N category, and postoperative chemotherapy were the independent predictors for overall survival for the patients with both early and overall recurrence.

Conclusion

Poor survival was associated with early postoperative recurrence for patients who underwent curative resection for colorectal cancer. The use of adjuvant chemotherapy prolonged the survival of patients, irrespective of the interval of recurrence.

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References

  1. Graham RA, Wang S, Catalano PJ, Haller DG (1998) Postsurgical surveillance of colon cancer: preliminary cost analysis of physician examination, carcinoembryonic antigen testing, chest x-ray, and colonoscopy. Ann Surg 228:59–63

    Article  PubMed  CAS  Google Scholar 

  2. Kjeldsen BJ, Kronborg O, Fenger C, Jorgensen OD (1997) A prospective randomized study of follow-up after radical surgery for colorectal cancer. Br J Surg 84:666–669

    Article  PubMed  CAS  Google Scholar 

  3. Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Tangen C (1993) An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer. JAMA 270:943–947

    Article  PubMed  CAS  Google Scholar 

  4. Galandiuk S, Wieand HS, Moertel CG, Cha SS, Fitzgibbons RJ Jr, Pemberton JH, Wolff BG (1992) Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 174:27–32

    PubMed  CAS  Google Scholar 

  5. Tsai HL, Chu KS, Huang YH, Su YC, Wu JY, Kuo CH, Chen CW, Wang JY (2009) Predictive factors of early relapse in UICC stage I-III colorectal cancer patients after curative resection. J Surg Oncol 100:736–743

    Article  PubMed  Google Scholar 

  6. Kaiser AM, Kang JC, Chan LS, Beart RW (2006) The prognostic impact of the time interval to recurrence for the mortality in recurrent colorectal cancer. Colorectal Dis 8:696–703

    Article  PubMed  CAS  Google Scholar 

  7. O'Connell MJ, Campbell ME, Goldberg RM, Grothey A, Seitz JF, Benedetti JK, Andre T, Haller DG, Sargent DJ (2008) Survival following recurrence in stage II and III colon cancer: findings from the ACCENT data set. J Clin Oncol 26:2336–2341

    Article  PubMed  Google Scholar 

  8. Kobayashi H, Mochizuki H, Morita T, Kotake K, Teramoto T, Kameoka S, Saito Y, Takahashi K, Hase K, Ohya M, Maeda K, Hirai T, Kameyama M, Shirouzu K, Sugihara K (2009) Timing of relapse and outcome after curative resection for colorectal cancer: a Japanese multicenter study. Dig Surg 26:249–255

    Article  PubMed  Google Scholar 

  9. Huh JW, Kim HR, Kim YJ (2010) Prognostic value of perineural invasion in patients with stage II colorectal cancer. Ann Surg Oncol 17:2066–2072

    Article  PubMed  Google Scholar 

  10. Huh JW, Kim HR, Kim YJ (2009) Proliferating cell nuclear antigen as a prognostic factor after total mesorectal excision of stage II–III rectal cancer. Ann Surg Oncol 16:1494–1500

    Article  PubMed  Google Scholar 

  11. Huh JW, Kim YJ, Kim HR (2010) Ratio of metastatic to resected lymph nodes as a prognostic factor in node-positive colorectal cancer. Ann Surg Oncol 17:2640–2646

    Article  PubMed  Google Scholar 

  12. Rosen M, Chan L, Beart RW Jr, Vukasin P, Anthone G (1998) Follow-up of colorectal cancer: a meta-analysis. Dis Colon Rectum 41:1116–1126

    Article  PubMed  CAS  Google Scholar 

  13. Eisenberg B, Decosse JJ, Harford F, Michalek J (1982) Carcinoma of the colon and rectum: the natural history reviewed in 1704 patients. Cancer 49:1131–1134

    Article  PubMed  CAS  Google Scholar 

  14. Obrand DI, Gordon PH (1997) Incidence and patterns of recurrence following curative resection for colorectal carcinoma. Dis Colon Rectum 40:15–24

    Article  PubMed  CAS  Google Scholar 

  15. Nelson H, Petrelli N, Carlin A, Couture J, Fleshman J, Guillem J, Miedema B, Ota D, Sargent D (2001) Guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst 93:583–596

    Article  PubMed  CAS  Google Scholar 

  16. Meguerditchian AN, Bairati I, Lagace R, Harel F, Kibrite A (2005) Prognostic significance of lymphovascular invasion in surgically cured rectal carcinoma. Am J Surg 189:707–713

    Article  PubMed  Google Scholar 

  17. Lim SB, Yu CS, Jang SJ, Kim TW, Kim JH, Kim JC (2010) Prognostic significance of lymphovascular invasion in sporadic colorectal cancer. Dis Colon Rectum 53:377–384

    Article  PubMed  Google Scholar 

  18. Wolmark N, Rockette H, Fisher B, Wickerham DL, Redmond C, Fisher ER, Jones J, Mamounas EP, Ore L, Petrelli NJ et al (1993) 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 11:1879–1887

    PubMed  CAS  Google Scholar 

  19. Bentzen SM, Balslev I, Pedersen M, Teglbjaerg PS, Hanberg-Sorensen F, Bone J, Jacobsen NO, Sell A, Overgaard J, Bertelsen K et al (1992) Time to loco-regional recurrence after resection of Dukes' B and C colorectal cancer with or without adjuvant postoperative radiotherapy. A multivariate regression analysis. Br J Cancer 65:102–107

    Article  PubMed  CAS  Google Scholar 

  20. Kang J, Min BS, Park YA, Hur H, Baik SH, Kim NK, Sohn SK, Lee KY (2009) Mucinous histology as a predictive marker of 5-fluorouracil-based adjuvant chemotherapy for colon cancer. J Korean Soc Coloproctol 25:241–247

    Article  Google Scholar 

  21. Huh JW, Kim YJ, Kim HR (2012) Distribution of lymph node metastases is an independent predictor of survival for sigmoid colon and rectal cancer. Ann Surg 255:70–81

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (grant no. 2012R1A1A1004888).

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Jung Wook Huh

  2. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, South Korea

    Chang Hyun Kim, Sang Woo Lim, Hyeong Rok Kim & Young Jin Kim

  3. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun, Jeollanam-do, 519-763, South Korea

    Hyeong Rok Kim

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  1. Jung Wook Huh
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  2. Chang Hyun Kim
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  3. Sang Woo Lim
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Correspondence to Hyeong Rok Kim.

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Huh, J.W., Kim, C.H., Lim, S.W. et al. Early recurrence in patients undergoing curative surgery for colorectal cancer: is it a predictor for poor overall survival?. Int J Colorectal Dis 28, 1143–1149 (2013). https://doi.org/10.1007/s00384-013-1675-z

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  • DOI: https://doi.org/10.1007/s00384-013-1675-z

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