Timing of relapse and outcome after curative resection for colorectal cancer: a Japanese multicenter study.
BACKGROUND
The aim of this multicenter study was to clarify the influence of timing of relapse after curative resection for colorectal cancer on prognosis.


METHODS
We enrolled 5,230 consecutive patients who underwent curative resection for colorectal cancer at 14 hospitals from 1991 to 1996. All patients were intensively followed up. Time to relapse (TR) was classified into three groups as follows: group A, TR < or =1 year; group B, TR >1 year and < or =3 years, and group C, TR >3 years. The prognoses after relapse were compared among the three groups.


RESULTS
Of the 5,230 patients, 906 experienced relapse (17.3%). The curative resection rates for recurrent tumors were 35.2% in group A, 46.6% in group B, and 45.1% in group C (p = 0.0045). There were significant differences in the prognoses after relapse among the three TR groups in patients with relapse to the liver (p = 0.0175) and in those with local relapses (p = 0.0021), but not in those with pulmonary or anastomotic recurrence. There were no differences in prognoses after relapse in any recurrence site among the three groups in patients who underwent curative resection for relapse.


CONCLUSIONS
If patients can undergo curative resection for relapse, they receive a survival benefit regardless of the timing of relapse.
Kobayashi
Hirotoshi
H
Department of Surgical Oncology, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan. h-kobayashi.srg2@tmd.ac.jp
Mochizuki
Hidetaka
H
Morita
Takayuki
T
Kotake
Kenjiro
K
Teramoto
Tatsuo
T
Kameoka
Shingo
S
Saito
Yukio
Y
Takahashi
Keiichi
K
Hase
Kazuo
K
Ohya
Masatoshi
M
Maeda
Koutarou
K
Hirai
Takashi
T
Kameyama
Masao
M
Shirouzu
Kazuo
K
Sugihara
Kenichi
K
D000714:Anastomosis, Surgical; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome