ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
Early Versus Late Recurrence in Rectal Cancer: Does Timing Matter?
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Temporal dynamics and determinants of early recurrence after curative resection for stage I-III rectal cancer: integrated analyses of hazard function, survival, and competing risks.Frontiers in oncology · 2026Article
- Identifying timing and risk factors for early recurrence of resectable rectal cancer: A single center retrospective study.World journal of gastrointestinal surgery · 2024Article
- Post recurrence survival in early versus late period and its prognostic factors in rectal cancer patients.Scientific reports · 2024Article
- A retrospective study analyzing if lymph node ratio carbon nanoparticles predict stage III rectal cancer recurrence.Frontiers in oncology · 2023Article
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11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe definition of early recurrence (ER) in rectal cancer is unclear, and the association of ER with post-recurrence survival (PRS) is poorly described. We therefore sought to identify if time to recurrence (TTR) is associated with PRS.
methodsWe reviewed all curative-intent resections of nonmetastatic rectal cancer from 2003 to 2018 in our institutional registry within an NCI-Designated Comprehensive Cancer Center. Clinicopathologic data at diagnosis and first recurrence were collected and analyzed. ER was pre-specified at < 24 months and late recurrence (LR) at ≥ 24 months. PRS was evaluated by the Kaplan-Meier method and Cox proportional hazards modeling.
resultsAt a median follow-up of 53 months, 61 out of 548 (11.1%) patients undergoing resection experienced recurrence. Median TTR was 14 months (IQR 10-18) with 45 of 61 patients (74%) classified as ER. There were no significant baseline differences between patients with ER and LR. Most recurrences were isolated to the liver (26%) or lung (31%), and 16% were locoregional. ER was not associated with worse PRS compared to LR (P > 0.99). On multivariable analysis, detection of recurrence via workup for symptoms, CEA > 10 ng/mL at recurrence, and site of recurrence were independently associated with PRS.
conclusionER is not associated with PRS in patients with resected rectal cancer. Symptomatic recurrences and those accompanied by CEA elevations are associated with worse PRS, while metastatic disease confined to the liver or lung is associated with improved PRS. Attention should be directed away from TTR and instead toward determining therapy for patients with treatable oligometastatic disease.
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