Stage dependent recurrence patterns and post-recurrence outcomes in non-metastatic colon cancer

Lucy Gately, Azim Jalali, Christine Semira, Ian Faragher, Matthew Croxford, Sumitra Ananda, Suzanne Kosmider, Kathryn Field, Sheau Wen Lok, Grace Gard, Malcolm Steel, Margaret Lee, Rachel Wong, Hui Li Wong, Peter Gibbs

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7 Citations (Scopus)


Background: Multiple meta-analyses have demonstrated that routine surveillance following colorectal cancer surgery improves survival outcomes. There is limited data on how recurrence patterns and post-recurrence outcomes vary by individual tumor stage. Methods: Using a multi-site community cohort study, we examined the potential impact of primary tumor stage on the sites of recurrence, management of recurrent disease with curative intent, and post-resection survival. We also explored changes over time. Results: Of 4257 new colon cancers diagnosed 2001 through 2016, 789 (21.1%) had stage I, 1584 (42.4%) had stage II, and 1360 (36.4%) had stage III colon cancer. For consecutive 5-year periods (2001–2005, 2006–2010, 2011–2016), recurrence rates have declined (23.4 vs. 17.1 vs. 13.6%, p < 0.001), however, the resection rates of metastatic disease (29.3 vs. 38.6 vs. 35.0%, p = 0.21) and post-resection 5-year survival (52.0 vs. 51.8 vs. 64.2%, p = 0.12) have remained steady. Primary tumor stage impacted recurrence rate (3.8 vs. 12 vs. 28%, p < 0.0001 for stage 1, 2, and 3), patterns of recurrence, resection of metastatic disease, (50 vs. 42 vs. 30%, p < 0.0001) and post-resection 5-year survival (92 vs. 64 vs. 44%, p < 0.001). Conclusion: In this community cohort we defined significant differences in recurrence patterns and post-resection survival by tumor stage, with a diminishing rate of recurrence over time. While recurrence rates were lower with stage I and II disease, the high rate of metastatic disease resection and excellent post-resection outcomes help to justify routine surveillance in these patients.

Original languageEnglish
Pages (from-to)1106-1113
Number of pages8
JournalActa Oncologica
Issue number9
Publication statusPublished - 2021


  • Colorectal cancer
  • staging
  • surveillance
  • survival

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