World Journal of Surgery

, Volume 41, Issue 4, pp 1126–1133 | Cite as

Identification of Recurrence—Predictive Indicators in Stage I Colorectal Cancer

  • Jun Ho Lee
  • Jong Lyul Lee
  • In Ja Park
  • Seok-Byung Lim
  • Chang Sik Yu
  • Jin Cheon KimEmail author
Original Scientific Report



Patients with stage I colorectal cancer (CRC) rarely experience recurrences; therefore, few risk factors for recurrence are known. This study was designed to evaluate oncologic outcomes of patients with stage I CRC and to identify risk factors for recurrence after curative surgery.


A retrospective cohort of 860 patients from a single institution who underwent curative surgery for stage I CRC between July 1995 and June 2010 was enrolled. Patients who were diagnosed with hereditary, synchronous, or metachronous cancer and those who received preoperative chemoradiotherapy were excluded. Patients from whom fewer than 12 lymph nodes were retrieved were also excluded.


The 860 patients included 402 (46.7%) with colon tumors and 458 (53.3%) with rectal tumors. Thirty-five patients (4.1%) experienced recurrences; local and systemic recurrence rates were 1.1 and 3.0%, respectively. The 5-year overall survival and recurrence-free survival (RFS) rates were 93.5 ± 0.8% and 95.7 ± 0.8%, respectively. Multivariate analysis showed that preoperative serum carcinoembryonic antigen (CEA) concentration ≥6 ng/mL (hazard ratio [HR] 3.354, 95% confidence interval [CI] 1.373–8.195, p = 0.008) and lymphovascular invasion (LVI) (HR 2.676, 95% CI 1.097–6.531, p = 0.031) were independent risk factors for RFS.


The overall recurrence rate among patients with stage I CRC after curative surgery was 4.1%. Elevated serum CEA and LVI were significantly associated with recurrence. Large-scale, multicenter studies are needed to confirm the prognostic value of these risk factors.


Rectal Cancer Familial Adenomatous Polyposis Rectal Cancer Patient Lower Rectal Cancer Systemic Recurrence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by Grants (to J.C. Kim) from the Korea Research Foundation (2013R1A2A1A03070986), Ministry of Science, ICT, and Future Planning, and the Korea Health 21 R&D Project (HI06C0868 and HI13C1750), Ministry of Health, Welfare, and Family Affairs, Republic of Korea.

Compliance with ethical standards

Conflict of interest


Supplementary material

268_2016_3833_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 kb)


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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Jun Ho Lee
    • 1
  • Jong Lyul Lee
    • 1
  • In Ja Park
    • 1
  • Seok-Byung Lim
    • 1
  • Chang Sik Yu
    • 1
  • Jin Cheon Kim
    • 1
    Email author
  1. 1.Department of SurgeryUniversity of Ulsan College of Medicine and Asan Medical CenterSongpa-gu, SeoulRepublic of Korea

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