Yudai Fukui1, Koya Hida2, Nobuaki Hoshino1, Daisuke Nishizaki1, Ryosuke Okamura1, Shinichi Yamauchi3, Kenichi Sugihara4, Yoshiharu Sakai1,5. 1. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan. 2. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan. hidakoya@kuhp.kyoto-u.ac.jp. 3. Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan. 4. Tokyo Medical and Dental University, Tokyo, Japan. 5. Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan.
Abstract
PURPOSE: Data regarding risk factors for recurrence in stage I colorectal cancer patients are limited. The aim of this study was to clarify the existence of a high-recurrence-risk population among stage I colorectal cancer patients. METHODS: This analysis included 7,539 stage I colorectal cancer patients treated between 1997 and 2012 at 24 leading hospitals in Japan. Risk factors for time to recurrence were evaluated using a Cox proportional hazards model, and a high-risk group for recurrence was identified. Prognostic outcomes of high-risk stage I colorectal cancer patients were compared with those of low-risk stage I and stage II patients. RESULTS: Multivariable analyses identified left-sided location (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.09-2.58), T2 tumors (HR: 1.80, 95% CI: 1.21-2.66), and lymphatic invasion (HR: 1.55, 95% CI: 1.05-2.28) as risk factors for recurrence in stage I colon cancer, and patients with these three risk factors were classified as high risk. For stage I rectal cancer, patients with poor differentiation (HR: 2.86, 95% CI: 1.21-5.69), T2 tumors (HR: 1.53, 95% CI: 1.07-2.23), and venous invasion (HR: 1.51, 95% CI: 1.08-2.13) were identified as high risk. The Kaplan-Meier analysis of cumulative recurrence rate and recurrence-free survival revealed that the high-risk stage I colorectal cancer patients have poorer clinical outcomes than the low-risk patients. CONCLUSION: Although stage I colorectal cancer patients generally have a favorable prognosis after curative surgery, poorer prognosis was observed in high-risk stage I colorectal cancer patients than in low-risk patients.
PURPOSE: Data regarding risk factors for recurrence in stage I colorectal cancer patients are limited. The aim of this study was to clarify the existence of a high-recurrence-risk population among stage I colorectal cancer patients. METHODS: This analysis included 7,539 stage I colorectal cancer patients treated between 1997 and 2012 at 24 leading hospitals in Japan. Risk factors for time to recurrence were evaluated using a Cox proportional hazards model, and a high-risk group for recurrence was identified. Prognostic outcomes of high-risk stage I colorectal cancer patients were compared with those of low-risk stage I and stage II patients. RESULTS: Multivariable analyses identified left-sided location (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.09-2.58), T2 tumors (HR: 1.80, 95% CI: 1.21-2.66), and lymphatic invasion (HR: 1.55, 95% CI: 1.05-2.28) as risk factors for recurrence in stage I colon cancer, and patients with these three risk factors were classified as high risk. For stage I rectal cancer, patients with poor differentiation (HR: 2.86, 95% CI: 1.21-5.69), T2 tumors (HR: 1.53, 95% CI: 1.07-2.23), and venous invasion (HR: 1.51, 95% CI: 1.08-2.13) were identified as high risk. The Kaplan-Meier analysis of cumulative recurrence rate and recurrence-free survival revealed that the high-risk stage I colorectal cancer patients have poorer clinical outcomes than the low-risk patients. CONCLUSION: Although stage I colorectal cancer patients generally have a favorable prognosis after curative surgery, poorer prognosis was observed in high-risk stage I colorectal cancer patients than in low-risk patients.
Authors: Michael J Hassett; Hajime Uno; Angel M Cronin; Nikki M Carroll; Mark C Hornbrook; Paul Fishman; Debra P Ritzwoller Journal: Cancer Epidemiol Date: 2017-07-12 Impact factor: 2.984
Authors: Cristina Bosetti; Fabio Levi; Valentina Rosato; Paola Bertuccio; Franca Lucchini; Eva Negri; Carlo La Vecchia Journal: Int J Cancer Date: 2010-11-16 Impact factor: 7.396
Authors: Jeffrey A Meyerhardt; Pamela B Mangu; Patrick J Flynn; Larissa Korde; Charles L Loprinzi; Bruce D Minsky; Nicholas J Petrelli; Kim Ryan; Deborah H Schrag; Sandra L Wong; Al B Benson Journal: J Clin Oncol Date: 2013-11-12 Impact factor: 44.544