Changing patterns of recurrent disease in colorectal cancer

Grossmann, I.; Doornbos, P. M.; Klaase, J.; de Bock, G. H.; Wiggers, T.

Changing patterns of recurrent disease in colorectal cancer

Journal article (2014)

Authors

I. Grossmann Medisch Spectrum Twente, University Medical Center Groningen

P. M. Doornbos University Medical Center Groningen

J. Klaase Medisch Spectrum Twente

G. H. de Bock University Medical Center Groningen

T. Wiggers University Medical Center Groningen

Affiliation

External organisation

Recurrence Colorectal neoplasms Follow-up studies MeSH keywords Neoplasm staging

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Published Date

2014

Language

English

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Abstract

Background Due to changes in staging, (neo)-adjuvant treatment and surgical techniques for colorectal cancer (CRC), it is expected that the recurrence pattern will change as well. This study aims to report the current incidence of, and time to recurrent disease (RD), further the localization(s) and the eligibility for successive curative treatment. Methods A consecutive cohort of CRC patients, whom were routinely staged with CT and underwent curative treatment according to the national guidelines, was analyzed (n = 526). Results After a mean and median FU of 39 months, 20% of all patients and 16% of all AJCC stage 0-III patients had developed RD. The annual incidences were the highest in the first two years but tend to retain in the succeeding years for stage 0-III patients. The majority of RD was confined to one organ (58%) and 28% of these patients were again treated with curative intent. Conclusions In follow-up nowadays, less recurrences are found than reported in historical studies but these can more often be treated with curative intent. A main cause for the decreased incidence of RD, next to improvements in treatment, is probably stage shift elicited by pre-operative staging. The outcomes support continuation of follow-up in colorectal cancer.