Hazard function analysis of metastatic recurrence after colorectal cancer surgery-A nationwide retrospective study.
colorectal cancer
metastasis
postoperative surveillance
recurrence
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
18
11
2020
revised:
28
12
2020
accepted:
30
12
2020
pubmed:
15
1
2021
medline:
11
3
2021
entrez:
14
1
2021
Statut:
ppublish
Résumé
An optimal postoperative surveillance protocol for colorectal cancer (CRC) is dependent on understanding the time line of recurrence. By hazard function analysis, this study aimed at evaluating the time of occurrence of metastasis. A total of 21,671 Stage I-III colon cancer patients were retrospectively included from the Japanese study group for postoperative follow-up of colorectal cancer database. The 5-year incidence by metastasized organ was 6.3% for liver (right:left = 5.5%:7.0%, p = .0067), 6.0% for lung (right:left:rectum = 3.7%:4.4%:8.8%, p = 7.05E-45), and 2.0% for peritoneal (right:left:rectum = 3.1%:2.0%:1.2%, p = 1.29E-12). The peak of liver metastasis hazard rate (HR) (0.67 years) was earlier and higher than those of other metastases. The peak HR tended to be delayed in early stage CRCs (0.91, 0.76, and 0.52 years; for Stages I, II, and III, respectively). When analyzed as per the primary tumor location (right-sided, left-sided, and rectum), the peak HR for lung metastasis was twice as high for rectal cancer than for colon cancer, and peritoneal metastasis had a high HR in right-sided colon cancers. The time course for the risk of recurrence in various metastatic organs based on the primary tumor site was clearly visualized in this study. This will aid in individualizing postoperative surveillance schedules.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
An optimal postoperative surveillance protocol for colorectal cancer (CRC) is dependent on understanding the time line of recurrence. By hazard function analysis, this study aimed at evaluating the time of occurrence of metastasis.
METHODS
METHODS
A total of 21,671 Stage I-III colon cancer patients were retrospectively included from the Japanese study group for postoperative follow-up of colorectal cancer database.
RESULTS
RESULTS
The 5-year incidence by metastasized organ was 6.3% for liver (right:left = 5.5%:7.0%, p = .0067), 6.0% for lung (right:left:rectum = 3.7%:4.4%:8.8%, p = 7.05E-45), and 2.0% for peritoneal (right:left:rectum = 3.1%:2.0%:1.2%, p = 1.29E-12). The peak of liver metastasis hazard rate (HR) (0.67 years) was earlier and higher than those of other metastases. The peak HR tended to be delayed in early stage CRCs (0.91, 0.76, and 0.52 years; for Stages I, II, and III, respectively). When analyzed as per the primary tumor location (right-sided, left-sided, and rectum), the peak HR for lung metastasis was twice as high for rectal cancer than for colon cancer, and peritoneal metastasis had a high HR in right-sided colon cancers.
CONCLUSION
CONCLUSIONS
The time course for the risk of recurrence in various metastatic organs based on the primary tumor site was clearly visualized in this study. This will aid in individualizing postoperative surveillance schedules.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1015-1022Subventions
Organisme : Japan Society for the Promotion of Science
ID : 18K07194
Organisme : Japan Society for the Promotion of Science
ID : 19K09114
Organisme : Japan Society for the Promotion of Science
ID : 19K09115
Organisme : Japan Society for the Promotion of Science
ID : 20K09051
Organisme : Japan Society for the Promotion of Science
ID : 20K21626
Organisme : Japan Agency for Medical Research and Development
ID : JP 19cm0106502
Informations de copyright
© 2021 Wiley Periodicals LLC.
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