Stage dependent recurrence patterns and post-recurrence outcomes in non-metastatic colon cancer

被引：12

作者：

Gately, Lucy ^{[1
,2
]}

Jalali, Azim ^{[1
,2
,3
]}

Semira, Christine ^{[1
]}

Faragher, Ian ^{[4
]}

Croxford, Matthew ^{[4
]}

Ananda, Sumitra ^{[1
,2
,3
,5
,6
]}

Kosmider, Suzanne ^{[3
]}

Field, Kathryn ^{[7
]}

Lok, Sheau Wen ^{[1
,2
,5
]}

Gard, Grace ^{[1
]}

Steel, Malcolm ^{[8
]}

Lee, Margaret ^{[1
,2
,9
]}

Wong, Rachel ^{[1
,9
,10
]}

Wong, Hui-Li ^{[1
,2
,5
]}

Gibbs, Peter ^{[1
,2
,3
]}

机构：

[1] Walter & Eliza Hall Inst Med Res, Personalised Oncol Div, Parkville, Vic, Australia

[2] Univ Melbourne, Dept Med Biol, Parkville, Vic, Australia

[3] Univ Melbourne, Western Hlth Med Sch, Dept Med Oncol, Footscray, Vic, Australia

[4] Univ Melbourne, Western Hlth Med Sch, Dept Surg, Footscray, Vic, Australia

[5] Peter MacCallum Canc Ctr, Dept Oncol, Parkville, Vic, Australia

[6] Epworth Freemasons, East Melbourne, Australia

[7] Royal Melbourne Hosp, Dept Med Oncol, Parkville, Vic, Australia

[8] Eastern Hlth, Dept Surg Oncol, Box Hill, Vic, Australia

[9] Eastern Hlth, Dept Med Oncol, Box Hill, Vic, Australia

[10] Monash Univ, Eastern Hlth Clin Sch, Box Hill, Vic, Australia

来源：

ACTA ONCOLOGICA | 2021年 / 60卷 / 09期

关键词：

Colorectal cancer; surveillance; survival; staging; INTENSIVE FOLLOW-UP; COLORECTAL-CANCER; CURATIVE RESECTION; AMERICAN SOCIETY; SURVEILLANCE; SURVIVAL; SURGERY; METASTASES; IMPACT;

D O I：

10.1080/0284186X.2021.1943519

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Multiple meta-analyses have demonstrated that routine surveillance following colorectal cancer surgery improves survival outcomes. There is limited data on how recurrence patterns and post-recurrence outcomes vary by individual tumor stage. Methods Using a multi-site community cohort study, we examined the potential impact of primary tumor stage on the sites of recurrence, management of recurrent disease with curative intent, and post-resection survival. We also explored changes over time. Results Of 4257 new colon cancers diagnosed 2001 through 2016, 789 (21.1%) had stage I, 1584 (42.4%) had stage II, and 1360 (36.4%) had stage III colon cancer. For consecutive 5-year periods (2001-2005, 2006-2010, 2011-2016), recurrence rates have declined (23.4 vs. 17.1 vs. 13.6%, p < 0.001), however, the resection rates of metastatic disease (29.3 vs. 38.6 vs. 35.0%, p = 0.21) and post-resection 5-year survival (52.0 vs. 51.8 vs. 64.2%, p = 0.12) have remained steady. Primary tumor stage impacted recurrence rate (3.8 vs. 12 vs. 28%, p < 0.0001 for stage 1, 2, and 3), patterns of recurrence, resection of metastatic disease, (50 vs. 42 vs. 30%, p < 0.0001) and post-resection 5-year survival (92 vs. 64 vs. 44%, p < 0.001). Conclusion In this community cohort we defined significant differences in recurrence patterns and post-resection survival by tumor stage, with a diminishing rate of recurrence over time. While recurrence rates were lower with stage I and II disease, the high rate of metastatic disease resection and excellent post-resection outcomes help to justify routine surveillance in these patients.

引用

页码：1106 / 1113

页数：8

共 24 条

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