Clinical and pathologic evaluation of patients with recurrence of colorectal cancer five or more years after curative resection.
OBJECTIVE
This study was designed to evaluate the characteristics of recurrences that occur five or more years after curative resection for colorectal cancer.


METHODS
This study included a total of 352 patients who were confirmed as having recurrence after curative resection for colorectal cancer during the period from January 1995 to December 2000. Of the 352 patients, 231 had early recurrence (less than 2 years after operation), 103 had intermediate recurrence (2-5 years after operation), and 18 had late recurrence (more than 5 years after operation). The clinicopathologic findings of the patients with late recurrence were compared with those of the other two recurrence groups, with special reference to the pattern of recurrence.


RESULTS
The rate of late recurrence was 1.2 percent. In the late recurrence group, males outnumbered females by a ratio of 3.5:1 and the mean level of preoperative carcinoembryonic antigen was 4.5 ng/ml, whereas that of the early recurrence group was 30.5 ng/ml. All the lesions in the cases with late recurrence except one lesion were located in the left colon or rectum, the tumors were small-sized and polypoid, and well-differentiated adenocarcinomas were more frequently observed. Distant metastasis, especially lung metastasis, was most frequently observed.


CONCLUSIONS
Late recurrent colorectal cancer has some characteristics compared with early or intermediate recurrence. Although recurrence at more than five years postoperatively is not common, its possibility should be considered whenever performing follow-up, and surveillance for lung metastasis is recommended after more than five years of surgery.
Cho
Yong Beom
YB
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Gangnam-Gu, Seoul, South Korea.
Chun
Ho-Kyung
HK
Yun
Hae Ran
HR
Lee
Won Suk
WS
Yun
Seong Hyeon
SH
Lee
Woo Yong
WY
D000293:Adolescent; D000328:Adult; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000556:secondary* / Q000601:surgery; D003110:Colonic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology*; D012004:Rectal Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
D002272:Carcinoembryonic Antigen