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

Authors

  • Lucy Gately Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Biology, The University of Melbourne, Parkville, Australia
  • Azim Jalali Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Biology, The University of Melbourne, Parkville, Australia; Department of Medical Oncology, Western Health Medical School, University of Melbourne, Footscray, Australia
  • Christine Semira Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia
  • Ian Faragher Department of Surgery, Western Health Medical School, University of Melbourne, Footscray, Australia
  • Matthew Croxford Department of Surgery, Western Health Medical School, University of Melbourne, Footscray, Australia
  • Sumitra Ananda Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Biology, The University of Melbourne, Parkville, Australia; Department of Medical Oncology, Western Health Medical School, University of Melbourne, Footscray, Australia; Department of Oncology, Peter MacCallum Cancer Centre, Parkville, Australia; Epworth Freemasons, East Melbourne, Australia
  • Suzanne Kosmider Department of Medical Oncology, Western Health Medical School, University of Melbourne, Footscray, Australia
  • Kathryn Field Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Australia
  • Sheau Wen Lok Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Biology, The University of Melbourne, Parkville, Australia; Department of Oncology, Peter MacCallum Cancer Centre, Parkville, Australia
  • Grace Gard Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia
  • Malcolm Steel Department of Surgical Oncology, Eastern Health, Box Hill, Australia
  • Margaret Lee Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Biology, The University of Melbourne, Parkville, Australia; Department of Medical Oncology, Eastern Health, Box Hill, Australia
  • Rachel Wong Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Oncology, Eastern Health, Box Hill, Australia; Eastern Health Clinical School, Monash University, Box Hill, Australia
  • Hui-Li Wong Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Biology, The University of Melbourne, Parkville, Australia; Department of Oncology, Peter MacCallum Cancer Centre, Parkville, Australia
  • Peter Gibbs Personalised Oncology Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Australia; Department of Medical Biology, The University of Melbourne, Parkville, Australia; Department of Medical Oncology, Western Health Medical School, University of Melbourne, Footscray, Australia

DOI:

https://doi.org/10.1080/0284186X.2021.1943519

Keywords:

Colorectal cancer, surveillance, survival, staging

Abstract

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.

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Published

2021-09-02

How to Cite

Gately, L. ., Jalali, A. ., Semira, C. ., Faragher, I. ., Croxford, M. ., Ananda, S. ., … Gibbs, P. . (2021). Stage dependent recurrence patterns and post-recurrence outcomes in non-metastatic colon cancer. Acta Oncologica, 60(9), 1106–1113. https://doi.org/10.1080/0284186X.2021.1943519

Issue

Vol. 60 No. 9 (2021): Acta Oncologica

Section

Articles