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Clinical outcomes of stage IV colorectal cancer after R0 resection: a multi-institutional retrospective analysis

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Abstract

Background

We analyzed the treatment outcomes after curative surgery for stage IV colorectal cancer to develop outcome-based follow-up protocols and treatment strategies.

Methods

This study was a multi-institutional retrospective analysis of treatment outcomes in patients who underwent R0 surgery for stage IV colorectal cancer.

Results

A total of 1133 patients, of whom 837 had recurrence, were included in this study. Recurrence occurred within 12 and 24 months after R0 surgery in 452 (54.0 %) and 652 (77.9 %) patients, respectively. Surgical resection was performed less frequently for recurrence within 12 months of R0 surgery than for recurrence after more than 12 months (p = 0.003). Prognosis was significantly better in patients who had recurrence more than 24 months after R0 surgery than in those who had recurrence within 24 months; this was not only for all patients but also specifically for patients with resection for recurrent disease. Recurrence was less frequent in patients who received preoperative chemotherapy than in patients who did not receive preoperative chemotherapy (p = 0.04). Of significance, fewer patients who received preoperative chemotherapy (57.5 %) had recurrence within 24 months compared with patients who did not receive preoperative chemotherapy (79.8 %) (p = 0.00001).

Conclusions

Intensive follow-up for at least 24 months was considered appropriate for monitoring disease recurrence after R0 surgery for stage IV colorectal cancer. In addition, preoperative chemotherapy contributed to improved outcomes.

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Acknowledgments

This paper was presented on behalf of the project team of the Japanese Study Group for Postoperative Follow-up of Colorectal Cancer. The authors thank the following institutional investigators for collecting the patient data—Masamichi Yasuno (Tokyo Medical and Dental University), Ichiro Takemasa (Sapporo Medical University), Kenichi Hakamada (Hirosaki University), Hitoshi Kameyama (Niigata University), Kazuo Hase (National Defense Medical University), Kenjiro Kotake (Tochigi Cancer Center), Toshiaki Watanabe (Tokyo University), Keiichi Takahashi (Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital), Yukihide Kanemitsu (National Cancer Center Hospital), Michio Itabashi (Tokyo Women’s Medical University), Hideo Yano (National Center for Global Health and Medicine), Masamichi Yasuno (Tokyo Medical and Dental University), Hirotoshi Hasegawa (Keio University), Yojiro Hashiguchi (Teikyo University), Tadahiko Masaki (Kyorin University), Masahiko Watanabe (Kitasato University), Koji Komori (Aichi Cancer Center Hospital), Yoshiharu Sakai (Kyoto University), and Masayuki Ohue (Osaka Medical Center for Cancer and Cardiovascular Diseases).

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Authors and Affiliations

  1. Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan

    Harunobu Sato, Koutarou Maeda & Zenichi Morise

  2. Department of Medical Statistics, Fujita Health University School of Medicine, Toyoake, Japan

    Hiroshi Takahashi

  3. Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan

    Kenichi Sugihara

Authors
  1. Harunobu Sato
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  2. Koutarou Maeda
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  3. Zenichi Morise
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  4. Hiroshi Takahashi
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  5. Kenichi Sugihara
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Consortia

Japanese Study Group for Postoperative Follow-up of Colorectal Cancer

Corresponding author

Correspondence to Harunobu Sato.

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All authors declare that there is no conflict of interest in this manuscript.

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Disclaimers: This study has not been presented in part elsewhere. We certify that no portion of this manuscript has been previously published, and is not under consideration by another journal.

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Sato, H., Maeda, K., Morise, Z. et al. Clinical outcomes of stage IV colorectal cancer after R0 resection: a multi-institutional retrospective analysis. Int J Clin Oncol 22, 297–306 (2017). https://doi.org/10.1007/s10147-016-1043-4

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  • DOI: https://doi.org/10.1007/s10147-016-1043-4

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