ArticleJournal of gastrointestinal cancer2026
Prognostic Factors for Cancer-Specific Survival after Recurrence in Chemo-Naïve Stage I-III Colorectal Cancer.
Article in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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14 authors.
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Abstract
backgroundSurvival after recurrence in colorectal cancer (CRC) is typically evaluated in adjuvant-treated Stage II-III patients, where therapy may select for resistant subclones and biologically modify recurrent tumors. Conversely, the natural history of recurrence in Stage I or chemo-naïve disease remains poorly characterized. We investigated prognostic determinants of cancer-specific survival after recurrence (CS-SAR) in a strictly chemo-naïve cohort.
methodsAmong 721 patients with pathological Stage I-III CRC who underwent curative resection without perioperative chemotherapy, we identified and analyzed 69 patients who developed recurrence. CS-SAR was analyzed using the Kaplan-Meier method and univariable and multivariable Cox models.
resultsInitial Stage I disease, oligometastasis, and salvage surgery were favorable prognostic factors, whereas early recurrence was associated with poor CS-SAR. In multivariable analysis, salvage surgery was strongly associated with favorable CS-SAR, whereas the association between oligometastatic status and CS-SAR was attenuated after adjustment of salvage surgery. Initial Stage I disease remained an independent favorable factor.
conclusionsRecurrent Stage I CRC may represent a clinically favorable subgroup, characterized by a tendency toward late, oligometastatic recurrence. These recurrence patterns may increase the feasibility of salvage surgery, which was strongly associated with long-term survival. Therefore, careful surveillance and multidisciplinary evaluation for curative-intent salvage strategies upon recurrence should be considered even for early-stage patients.
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