title: Changing patterns of recurrent disease in colorectal cancer.
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.
authors.affiliation: Department of Surgery, Medical Spectrum Twente, Haaksbergerstraat 55, 7513 ER Enschede, The Netherlands. Electronic address: irenegrossmann@me.com.
authors.forename: I
authors.initials: I
authors.lastname: Grossmann
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
authors.forename: P M
authors.initials: PM
authors.lastname: Doornbos
authors.affiliation: Department of Surgery, Medical Spectrum Twente, Haaksbergerstraat 55, 7513 ER Enschede, The Netherlands. Electronic address: J.Klaase@mst.nl.
authors.forename: J M
authors.initials: JM
authors.lastname: Klaase
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: g.h.de.bock@umcg.nl.
authors.forename: G H
authors.initials: GH
authors.lastname: de Bock
authors.affiliation: Department of Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: T.wiggers@umcg.nl.
authors.forename: T
authors.initials: T
authors.lastname: Wiggers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology* / Q000556:secondary; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000556:secondary; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000453:epidemiology* / Q000556:secondary; D013997:Time Factors
keywords: Colorectal neoplasms; Follow-up studies; Neoplasm staging; Recurrence