Predictive factors and the prognosis of recurrence of colorectal cancer within 2 years after curative resection.
OBJECTIVE
Because predicting recurrence intervals and patterns would allow for appropriate therapeutic strategies, we evaluated the clinical and pathological characteristics of early and late recurrences of colorectal cancer.


METHODS
Patients who developed recurrence after undergoing curative resection for colorectal cancer stage I-III between January 2000 and May 2006 were identified. Early recurrence was defined as recurrence within 2 years after primary surgery of colorectal cancer. Analyses were performed to compare the clinicopathological characteristics and overall survival rate between the early and late recurrence groups.


RESULTS
One hundred fifty-eight patients experienced early recurrence and 64 had late recurrence. Multivariate analysis revealed that the postoperative elevation of carbohydrate antigen 19-9 (CA 19-9), venous invasion, and N stage correlated with the recurrence interval. The liver was the most common site of early recurrence (40.5%), whereas late recurrence was more common locally (28.1%), or in the lung (32.8%). The 5-year overall survival rates for early and late recurrence were significantly different (34.7% vs. 78.8%; P < 0.001). Survival rates after the surgical resection of recurrent lesions were not different between the two groups.


CONCLUSIONS
Early recurrence within 2 years after surgery was associated with poor survival outcomes after colorectal cancer recurrence. An elevated postoperative CA 19-9 level, venous invasion, and advanced N stage were found to be significant risk factors for early recurrence of colorectal cancer.
Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.
Jong Pil
JP
Ryuk
Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.
Gyu-Seog
GS
Choi
Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.
Jun Seok
JS
Park
Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.
Hye Jin
HJ
Kim
Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.
Soo Yeun
SY
Park
Department of Pathology, Kyungpoook National University School of Medicine, Daegu, Korea.
Ghil Suk
GS
Yoon
Department of Surgery, Catholic University of Daegu School of Medicine, Daegu, Korea.
Soo Han
SH
Jun
Department of Pathology, Catholic University of Daegu School of Medicine, Daegu, Korea.
Yong Chul
YC
Kwon
Colorectal neoplasms; Recurrence; Recurrence interval; Risk factors; Survival