Evidence map›Paper›PMID 42611140›Full record

ArticleInternational journal of clinical oncology2026

Second recurrence after R0 resection of recurrent colorectal cancer: patterns and implications for surveillance.

Haruku Fujita, Ryosuke Okamura, Ben Sasaki, Nobu Oshima, Rei Mizuno, Takamasa Yamamoto, Shusaku Honma, Satoshi Nagayama, Kentaro Goto, Yoshiro Itatani and 2 more

Abstract read
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Article in International journal of clinical oncology, 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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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Haruku FujitaDepartment of Surgery, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Ryosuke OkamuraDepartment of Surgery, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. rokamura@kuhp.kyoto-u.ac.jp.ORCID http://orcid.org/0000-0001-7352-8621
Ben SasakiDepartment of Surgery, Shiga General Hospital, Moriyama, Japan.
Nobu OshimaDepartment of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Rei MizunoDepartment of Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Takamasa YamamotoDepartment of Surgery, Kobe City Nishi-Kobe Medical Center, Kobe, Japan.
Shusaku HonmaDepartment of Surgery, Kobe City Medical Center West Hospital, Kobe, Japan.
Satoshi NagayamaDepartment of Surgery, Uji-Tokushukai Medical Center, Uji, Japan.
Kentaro GotoDepartment of Surgery, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Yoshiro ItataniDepartment of Surgery, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Koya HidaDepartment of Surgery, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Kazutaka ObamaDepartment of Surgery, Kyoto University Hospital, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Funding

Japan Society for the Promotion of Science 21 K16416
6 · The paper itself

Abstract

backgroundAlthough repeat metastasectomy can improve survival in selected patients with colorectal cancer (CRC), the patterns and timing of second recurrence remain unclear.

methodsWe conducted a multi-institutional study of 365 patients who underwent curative intent (R0) resection for their first recurrent CRC between 2008 and 2020. Timing and site of second recurrence were assessed. The median follow-up duration from resection of the first recurrence was 4.9 years.

resultsSecond recurrence occurred in 206 of 365 patients (56.4%). The 5-year cumulative incidence remained substantial even among patients with early-stage primary disease: 40.7% for stage I, 47.6% for stage II, 63.1% for stage III, and 71.0% for stage IV. Notably, more than 90% of second recurrences occurred within 2 years after resection of first recurrence, and none occurred beyond 5 years, regardless of primary tumor stage or site of the first recurrence. Among patients with stage I-III disease, 54.9% experienced recurrence at the same site as the first recurrence. R0 resection of the second recurrence was achieved in 50.5% of patients, yielding a 5-year overall survival of 62.5%.

conclusionsThe risk of second recurrence remains consistently high across all primary tumor stages and was concentrated within 2 years after resection of recurrent CRC. Nevertheless, nearly half of patients are amenable to repeat curative-intent resection, leading to favorable long-term outcomes. These findings underscore the need for surveillance strategies explicitly designed to detect second recurrences during this critical early period.

Indexed as

Recurrence patternRecurrent colorectal cancerRepeat metastasectomySecond recurrenceSurveillance strategy

Identifiers

PMID42611140

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