Evaluation of Recurrence Risk After Curative Resection for Patients With Stage I to III Colorectal Cancer Using the Hazard Function: Retrospective Analysis of a Single-institution Large Cohort. Issue 4 (11th April 2022)

• Record Type: Journal Article
• Authors: Kudose, Yozo; Shida, Dai; Ahiko, Yuka; Nakamura, Yuya; Sakamoto, Ryohei; Moritani, Konosuke; Tsukamoto, Shunsuke; Kanemitsu, Yukihide
• Is Part Of: Annals of surgery. Volume 275:Issue 4(2022)
• Page Start: 727
• Page End: 734
• Publication Date: 2022-04-11
• Subjects: colorectal cancer -- hazard function -- recurrence -- surveillance; Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000004058
• Languages: English
• ISSNs: 0003-4932

Abstract

Abstract : Objective: This study aimed to investigate transitions of recurrence hazard and peak recurrence time in patients with nonmetastatic CRC using the hazard function. Summary of Background Data: A postoperative surveillance period of 5 years is consistent across major guidelines for patients with nonmetastatic CRC, but surveillance intervals differ. Estimates of instantaneous conditional recurrence rate can help set appropriate intervals. Methods: The study population consisted of 4330 patients with stage I to III CRC who underwent curative resection at the National Cancer Center Hospital between January 2000 and December 2013. Hazard rates of recurrence were calculated using the hazard function. Results: Recurrence rates in patients with stage I, II, and III CRC were 4% (50/1432), 11% (136/1231), and 25% (424/1667), respectively. The hazard curve for stage I was relatively flat and hazard rates were consistently low (<0.0015) for 5 years after surgery. The hazard curve for stage II had a peak hazard rate of 0.0046 at 13.7 months, after which the curve had a long hem to the right. The hazard curve for stage III had an earlier and higher peak than that of stage II (0.0105 at 11.6 months), with a long hem to the right. Conclusions: Changes in recurrence hazard for CRC patients varied considerably by stage. Our findings suggest that short-interval surveillance might be unnecessary for stage I patients for the first 3 years after surgery, whereas short-interval surveillance for the first 3 years should be considered for stage III patients.