Purpose
This study was designed to evaluate the characteristics of recurrences that occur five or more years after curative resection for colorectal cancer.
Methods
This study included a total of 352 patients who were confirmed as having recurrence after curative resection for colorectal cancer during the period from January 1995 to December 2000. Of the 352 patients, 231 had early recurrence (less than 2 years after operation), 103 had intermediate recurrence (2–5 years after operation), and 18 had late recurrence (more than 5 years after operation). The clinicopathologic findings of the patients with late recurrence were compared with those of the other two recurrence groups, with special reference to the pattern of recurrence.
Results
The rate of late recurrence was 1.2 percent. In the late recurrence group, males outnumbered females by a ratio of 3.5:1 and the mean level of preoperative carcinoembryonic antigen was 4.5 ng/ml, whereas that of the early recurrence group was 30.5 ng/ml. All the lesions in the cases with late recurrence except one lesion were located in the left colon or rectum, the tumors were small-sized and polypoid, and well-differentiated adenocarcinomas were more frequently observed. Distant metastasis, especially lung metastasis, was most frequently observed.
Conclusions
Late recurrent colorectal cancer has some characteristics compared with early or intermediate recurrence. Although recurrence at more than five years postoperatively is not common, its possibility should be considered whenever performing follow-up, and surveillance for lung metastasis is recommended after more than five years of surgery.
Similar content being viewed by others
References
U Carlsson A Lasson G Ekelund (1987) ArticleTitleRecurrence rates after curative surgery for rectal carcinoma, with special reference to their accuracy Dis Colon Rectum 30 431–434 Occurrence Handle3595361 Occurrence Handle10.1007/BF02556491 Occurrence Handle1:STN:280:DyaL2s3ksF2lsw%3D%3D
S Galandiuk HS Wieand CG Moertel et al. (1992) ArticleTitlePatterns of recurrence after curative resection of carcinoma of the colon and rectum Surg Gynecol Obstet 174 27–32 Occurrence Handle1729745 Occurrence Handle1:STN:280:DyaK387gvVGnsQ%3D%3D
S Stipa V Nicolanti C Botti et al. (1991) ArticleTitleLocal recurrence after curative resection for colorectal cancer: frequency, risk factors and treatment J Surg Oncol Suppl 2 155–160 Occurrence Handle1892525 Occurrence Handle10.1002/jso.2930480532 Occurrence Handle1:STN:280:DyaK3MzmvFChtA%3D%3D
SH Landis T Murray S Bolden PA Wingo (1999) ArticleTitleCancer statistics, 1999 CA Cancer J Clin 49 8–31 Occurrence Handle10200775 Occurrence Handle1:STN:280:DyaK1M3hs1OrsA%3D%3D Occurrence Handle10.3322/canjclin.49.1.8
A Castells X Bessa M Daniels et al. (1998) ArticleTitleValue of postoperative surveillance after radical surgery for colorectal cancer: results of a cohort study Dis Colon Rectum 41 714–723 Occurrence Handle9645739 Occurrence Handle10.1007/BF02236257 Occurrence Handle1:STN:280:DyaK1czgslKksw%3D%3D
EL Bokey B Ojerskog PH Chapuis OF Dent RC Newland G Sinclair (1999) ArticleTitleLocal recurrence after curative excision of the rectum for cancer without adjuvant therapy: role of total anatomical dissection Br J Surg 86 1164–1170 Occurrence Handle10504371 Occurrence Handle10.1046/j.1365-2168.1999.01216.x Occurrence Handle1:STN:280:DyaK1Mvjs1Kltw%3D%3D
HC Umpleby JB Bristol JB Rainey RC Williamson (1984) ArticleTitleSurvival of 727 patients with single carcinomas of the large bowel Dis Colon Rectum 27 803–810 Occurrence Handle6499620 Occurrence Handle10.1007/BF02553944 Occurrence Handle1:STN:280:DyaL2M%2FltVKkug%3D%3D
S Sadahiro T Suzuki K Ishikawa et al. (2003) ArticleTitleRecurrence patterns after curative resection of colorectal cancer in patients followed for a minimum of ten years Hepatogastroenterology 50 1362–1366 Occurrence Handle14571738
KE Blake MH Dalbow JP Concannon et al. (1982) ArticleTitleClinical significance of the preoperative plasma carcinoembryonic antigen (CEA) level in patients with carcinoma of the large bowel Dis Colon Rectum 25 24–32 Occurrence Handle7056138 Occurrence Handle10.1007/BF02553544 Occurrence Handle1:STN:280:DyaL387hs1Gmtw%3D%3D
DZ Chu CA Erickson MP Russell et al. (1991) ArticleTitlePrognostic significance of carcinoembryonic antigen in colorectal carcinoma. Serum levels before and after resection and before recurrence Arch Surg 126 314–316 Occurrence Handle1998473 Occurrence Handle1:STN:280:DyaK3M7ltFaltQ%3D%3D
LE Harrison JG Guillem P Paty AM Cohen (1997) ArticleTitlePreoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients: a multivariate analysis of 572 patients J Am Coll Surg 185 55–59 Occurrence Handle9208961 Occurrence Handle1:STN:280:DyaK2szlt1GltA%3D%3D
LA Carriquiry A Pineyro (1999) ArticleTitleShould carcinoembryonic antigen be used in the management of patients with colorectal cancer? Dis Colon Rectum 42 921–929 Occurrence Handle10411440 Occurrence Handle10.1007/BF02237104 Occurrence Handle1:STN:280:DyaK1MzjslantQ%3D%3D
B Eisenberg JJ Decosse F Harford J Michalek (1982) ArticleTitleCarcinoma of the colon and rectum: the natural history reviewed in 1704 patients Cancer 49 1131–1134 Occurrence Handle7059938 Occurrence Handle10.1002/1097-0142(19820315)49:6<1131::AID-CNCR2820490611>3.0.CO;2-T Occurrence Handle1:STN:280:DyaL387js1KhsA%3D%3D
F Crucitti L Sofo GB Doglietto et al. (1991) ArticleTitlePrognostic factors in colorectal cancer: current status and new trends J Surg Oncol Suppl 2 76–82 Occurrence Handle1892535 Occurrence Handle10.1002/jso.2930480518 Occurrence Handle1:STN:280:DyaK3MzmvFCnsA%3D%3D
DI Obrand PH Gordon (1997) ArticleTitleIncidence and patterns of recurrence following curative resection for colorectal carcinoma Dis Colon Rectum 40 15–24 Occurrence Handle9102255 Occurrence Handle10.1007/BF02055676 Occurrence Handle1:STN:280:DyaK2s3isl2qtQ%3D%3D
B Fisher N Wolmark H Rockette et al. (1988) ArticleTitlePostoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01 J Natl Cancer Inst 80 21–29 Occurrence Handle3276900 Occurrence Handle10.1093/jnci/80.1.21 Occurrence Handle1:STN:280:DyaL1c7hvFSjsQ%3D%3D
CG Moertel TR Fleming JS Macdonald et al. (1990) ArticleTitleLevamisole and fluorouracil for adjuvant therapy of resected colon carcinoma N Engl J Med 322 352–358 Occurrence Handle2300087 Occurrence Handle1:STN:280:DyaK3c7js1Ohsw%3D%3D Occurrence Handle10.1056/NEJM199002083220602
N Wolmark H Rockette B Fisher et al. (1993) ArticleTitleThe 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 Occurrence Handle8410113 Occurrence Handle1:STN:280:DyaK2c%2FhsFajtw%3D%3D
L Weiss E Grundmann J Torhorst et al. (1986) ArticleTitleHaematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies J Pathol 150 195–203 Occurrence Handle3806280 Occurrence Handle10.1002/path.1711500308 Occurrence Handle1:STN:280:DyaL2s7htF2msA%3D%3D
DJ Bruinvels AM Stiggelbout J Kievit HC van Houwelingen JD Habbema CJ van de Velde (1994) ArticleTitleFollow-up of patients with colorectal cancer. A meta-analysis Ann Surg 219 174–182 Occurrence Handle8129488 Occurrence Handle10.1097/00000658-199402000-00009 Occurrence Handle1:STN:280:DyaK2c7nsFKgug%3D%3D
J Ovaska H Jarvinen H Kujari I Perttila JP Mecklin (1990) ArticleTitleFollow-up of patients operated on for colorectal carcinoma Am J Surg 159 593–596 Occurrence Handle2349988 Occurrence Handle1:STN:280:DyaK3c3nsVSqsg%3D%3D
VF Eckardt H Stamm G Kanzler G Bernhard (1994) ArticleTitleImproved survival after colorectal cancer in patients complying with a postoperative endoscopic surveillance program Endoscopy 26 523–527 Occurrence Handle7828564 Occurrence Handle1:STN:280:DyaK2M7ivFGiug%3D%3D Occurrence Handle10.1055/s-2007-1009027
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Cho, Y.B., Chun, HK., Yun, H.R. et al. Clinical and Pathologic Evaluation of Patients with Recurrence of Colorectal Cancer Five or More Years After Curative Resection. Dis Colon Rectum 50, 1204–1210 (2007). https://doi.org/10.1007/s10350-007-0247-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10350-007-0247-0