After patients with stage IV colorectal cancer undergo curative surgical resection, there is a large risk for recurrence.
To establish optimal surveillance guidelines, an understanding of the temporal risk factors for recurrence is necessary.
Dr Tomokazu Kishiki and colleagues determined predictors for early, middle, and late recurrence following curative resection in patients with stage IV colorectal cancer.
The researchers performed a retrospective cohort study conducted at multiple institutions.
The retrospective cohort study comprized 1070 patients with stage IV colorectal cancer after an R0 resection for the primary and metastatic lesions in 19 institutions from 1997 to December 2007.
|The overall recurrence rate was 73%|
|Diseases of the Colon & Rectum|
Risk factors for early, middle, and late recurrence were determined by logistic regression and Cox proportional hazards models.
The research team found that the overall recurrence rate was 73%.
Cancer-specific survival was 30 months, and recurrence-free survival was 9 months.
The team noted that early recurrence occurred in 62%, middle recurrence in 24%, and late recurrence in 14%.
The researchers found that early recurrence risk factors included rectum site, depth of tumor invasion (T4), increasing N-staging, venous invasion, and liver metastasis.
Late recurrence risk factors were tumor size ≤50 mm, and peritoneal dissemination.
Dr Kishiki's team concludes, "Risk factors differ for early, middle, and late recurrences of stage IV colorectal cancer following curative resection."
"Early recurrence factors were rectum site, T4, N-staging, venous invasion, and liver metastasis, whereas late recurrence risk factors were small tumor size and peritoneal dissemination."
"Our study provides important data to guide a surveillance protocol following stage IV colorectal cancer curative resection."