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. 2021 Nov;36(11):2399-2410.
doi: 10.1007/s00384-021-03914-w. Epub 2021 Apr 4.

Disease recurrence after colorectal cancer surgery in the modern era: a population-based study

Seyed M Qaderi  1   2 , Boris Galjart  3 , Cornelis Verhoef  3 , Gerrit D Slooter  4 , Miriam Koopman  5 , Robert H A Verhoeven  6   7 , Johannes H W de Wilt  6 , Felice N van Erning  7
Affiliations

Disease recurrence after colorectal cancer surgery in the modern era: a population-based study

Seyed M Qaderi et al. Int J Colorectal Dis. 2021 Nov.

Abstract

Purpose: This population-based study determined the cumulative incidence (CI) of local, regional, and distant recurrences, examined metastatic patterns, and identified risk factors for recurrence after curative treatment for CRC.

Methods: All patients undergoing resection for pathological stage I-III CRC between January 2015 and July 2015 and registered in the Netherlands Cancer Registry were selected (N = 5412). Additional patient record review and data collection on recurrences was conducted by trained administrators in 2019. Three-year CI of recurrence was calculated according to sublocation (right-sided: RCC, left-sided: LCC and rectal cancer: RC) and stage. Cox competing risk regression analyses were used to identify risk factors for recurrence.

Results: The 3-year CI of recurrence for stage I, II, and III RCC and LCC was 0.03 vs. 0.03, 0.12 vs. 0.16, and 0.31 vs. 0.24, respectively. The 3-year CI of recurrence for stage I, II, and III RC was 0.08, 0.24, and 0.38. Distant metastases were found in 14, 12, and 16% of patients with RCC, LCC, and RC. Multiple site metastases were found often in patients with RCC, LCC, and RC (42 vs. 32 vs. 28%). Risk factors for recurrence in stage I-II CRC were age 65-74 years, pT4 tumor size, and poor tumor differentiation whereas in stage III CRC, these were ASA III, pT4 tumor size, N2, and poor tumor differentiation.

Conclusions: Recurrence rates in recently treated patients with CRC were lower than reported in the literature and the metastatic pattern and recurrence risks varied between anatomical sublocations.

Keywords: Colorectal neoplasm; Distant metastasis; Follow-up studies; Locoregional; Recurrence.

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Conflict of interest statement

Rob Verhoeven received research grants, not related to this work, from Roche and Bristol-Myers Squibb. The other authors have nothing to declare.

Figures

Fig. 1
Fig. 1
Three-year cumulative incidence of recurrence among patients with right-sided colon and left-sided colon and rectal cancer. Gray’s test: P < 0.0001
Fig. 2
Fig. 2
Three-year cumulative incidence of recurrence by primary tumor stage among patients with right-sided colon and left-sided colon cancer. Gray’s test: P < 0.0001
Fig. 3
Fig. 3
Three-year cumulative incidence of recurrence by primary tumor stage among patients with rectal cancer. Gray’s test: P < 0.0001
See this image and copyright information in PMC

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