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Surgery. 2007 Jan;141(1):67-75. Epub 2006 Sep 14.

Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study.

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1
Study Group of the Japanese Society for Cancer of the Colon and Rectum (JSCCR) on Postsurgical Surveillance of Colorectal Cancer: Department of Surgery I, National Defense Medical College, Tokyo, Japan. h-kobayashi.srg2@tmd.ac.jp

Abstract

BACKGROUND:

The aim of this study was to clarify the characteristics of recurrence and the effectiveness of surveillance tools after curative resection for colorectal cancer.

METHODS:

We enrolled 5230 consecutive patients (stage I, 1367; stage II, 1912; stage III, 1951) who underwent curative resection at 14 hospitals from 1991 to 1996. All patients were followed up intensively, and their outcomes were investigated retrospectively.

RESULTS:

Of the 5230 patients, 906 developed recurrence. The recurrence rates of stage I, II, and III cancers were 3.7%, 13.3%, and 30.8%, respectively (P < .0001). The curves of the cumulative appearance rate of recurrence in stage II and III patients showed a rapid increase for the first 3 years. Recurrence after 5 years was less than 1% in each stage. Clinical visits combined with measurements of tumor markers detected the majority of recurrences except in the case of lung metastasis. In contrast, 43.4% of hepatic recurrences were detected by liver imaging, and 48.4% of pulmonary recurrences were noted by chest x-ray. The 5-year survival rates after primary colorectal surgery in patients who underwent resection for recurrence were better than in those without resection: 55% vs 11% in hepatic recurrence, 68% vs 13% in pulmonary recurrence, and 48% vs 22% in local recurrence (all P < .001).

CONCLUSION:

It is useful to take these characteristics of recurrence into account in the management of patients after curative resection for colorectal cancer and in the setting of clinical trial for follow-up after curative resection for colorectal cancer.

PMID:
17188169
DOI:
10.1016/j.surg.2006.07.020
[Indexed for MEDLINE]
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