Clinicopathological Characteristics and Prognosis of Patients According to Recurrence Time After Curative Resection for Colorectal Cancer

  • Bozkurt, Oktay (Department of Medical Oncology, Erciyes University Faculty of Medicine) ;
  • Inanc, Mevlude (Medical Oncology Department, Kayseri Training and Research Hospital) ;
  • Turkmen, Esma (Department of Medical Oncology, Trakya University Faculty of Medicine) ;
  • Karaca, Halit (Department of Medical Oncology, Erciyes University Faculty of Medicine) ;
  • Berk, Veli (Department of Medical Oncology, Erciyes University Faculty of Medicine) ;
  • Duran, Ayse Ocak (Department of Medical Oncology, Erciyes University Faculty of Medicine) ;
  • Ozaslan, Ersin (Department of Medical Oncology, Erciyes University Faculty of Medicine) ;
  • Ucar, Mahmut (Department of Medical Oncology, Erciyes University Faculty of Medicine) ;
  • Hacibekiroglu, Ilhan (Department of Medical Oncology, Trakya University Faculty of Medicine) ;
  • Eker, Baki (Internal Medicine Department, Kayseri Training and Research Hospital) ;
  • Baspinar, Osman (Internal Medicine Department, Kayseri Training and Research Hospital) ;
  • Ozkan, Metin (Department of Medical Oncology, Erciyes University Faculty of Medicine)
  • Published : 2014.11.28


Purpose: To investigate clinicopathological features in patients with recurrent colorectal cancer within 1 year and more than 1 year after curative resection. Materials and Methods: We retrospectively evaluated 103 patients with disease recurrence before versus after 1 year of resection. Thirty-two patients (31%) were diagnosed with recurrence less than 1 year after curative resection for colorectal cancer (early recurrence) and 71 (69%) after more than 1 year (non-early recurrence). Results: The early recurrence group displayed a significantly lower overall survival rate for both colon cancer (p=0, 01) and rectal cancer (p<0.001). Inadequate lymph node dissection was a significant predictor for early relapse. There were no statistically significant differences in clinicopathological variables such as age, sex, primary tumor localization, stage, depth of invasion, lymphovascular invasion and perineural invasion between the early and non-early recurrence groups. However, a K-ras mutation subgroup was significantly associated with early recurrence (p<0.001). Conclusions: Poor survival is associated with early recurrence for patients undergoing resection for non-metastatic colorectal cancer, as well as K-ras mutation.


  1. Abulafi AM, Williams NS (1994). Local recurrence of colorectal cancer: the problem, mechanisms, management and adjuvant therapy. Br J Surg, 81, 7-19.
  2. Bentzen SM, Balslev I, Pedersen M, et al (1992). Time to loco-regional recurrence after resection of Dukes' B and C colorectal cancer with or without adjuvant postoperative radiotherapy. A multivariate regression analysis. Br J Cancer, 65, 102-7.
  3. Bokemeyer C, Bondarenko I, Makhson A, et al (2009). Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol, 27, 663-71.
  4. Ding YL, Wang QS, Zhao WM, et al (2012). Expression of smoothened protein in colon cancer and its prognostic value for postoperative liver metastasis. Asian Pac J Cancer Prev, 13, 4001-5.
  5. Douillard JY, Siena S, Cassidy J, et al (2010). Randomized, phase III trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as first-line treatment in patients with previously untreated metastatic colorectal cancer: the PRIME study. J Clin Oncol, 28, 4697-705.
  6. Eisenberg B, Decosse JJ, Harford F, Michalek J (1982). Carcinoma of the colon and rectum: the natural history reviewed in 1704 patients. Cancer, 49, 1131-4.<1131::AID-CNCR2820490611>3.0.CO;2-T
  7. Fang WJ, Zheng Y, Wu LM, et al (2012). Genome-wide analysis of aberrant DNA methylation for identification of potential biomarkers in colorectal cancer patients. Asian Pac J Cancer Prev, 13, 1917-21.
  8. Galandiuk S, Wieand HS, Moertel CG, et al (1992). Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet, 174, 27-32.
  9. Graham RA, Wang S, Catalano PJ, Haller DG (1998). Postsurgical surveillance of colon cancer: preliminary cost analysis of physician examination, carcinoembryonic antigen testing, chest x-ray, and colonoscopy. Ann Surg, 228, 59-63.
  10. Hu Y, Wang JL, Tao HT, et al (2013). Expression and significance of TSGF, CEA and AFP in patients before and after radical surgery for colon cancer. Asian Pac J Cancer Prev, 14, 3877-80.
  11. Huh JW, Kim CH, Lim SW, Kim HR, Kim YJ (2013). Early recurrence in patients undergoing curative surgery for colorectal cancer: is it a predictor for poor overall survival?. Int J Colorectal Dis, 28, 1143-9.
  12. Jemal A, Siegel R, Xu J, Ward E (2010). Cancer Statistics. CA Cancer J Clin, 60, 277-300.
  13. Huh JW, Kim YJ, Kim HR (2012). Distribution of lymph node metastases is an independent predictor of survival for sigmoid colon and rectal cancer. Ann Surg, 255, 70-81.
  14. Kaiser AM, Kang JC, Chan LS, Beart RW(2006). The prognostic impact of the time interval to recurrence for the mortality in recurrent colorectal cancer. Colorectal Dis, 8, 696-703.
  15. Karaca H, Berk V, Inanc M, Dikilitas M, Ozkan M (2011). Epidemiologic evaluation of the patients admitted to Department of Medical Oncology, Erciyes University, Medical Faculty, between 2006 and 2009. J Health Sciences, 20, 1-8.
  16. Kjeldsen BJ, Kronborg O, Fenger C, Jorgensen OD (1997). A prospective randomized study of follow-up after radical surgery for colorectal cancer. Br J Surg, 84, 66-9.
  17. Kobayashi H, Mochizuki H, Morita T, et al (2009).Timing of relapse and outcome after curative resection for colorectal cancer: a Japanese multicenter study. Dig Surg, 26, 249-55.
  18. Li ZT, Zhang L, Gao XZ, et al (2013). Expression and significance of the Wip1 proto-oncogene in colorectal cancer. Asian Pac J Cancer Prev, 14, 1975-9.
  19. Lim SB, Yu CS, Jang SJ, et al (2010). Prognostic significance of lymphovascular invasion in sporadic colorectal cancer. Dis Colon Rectum, 53, 377-84.
  20. Meguerditchian AN, Bairati I, Lagace R, Harel F, Kibrite A (2005). Prognostic significance of lymphovascular invasion in surgically cured rectal carcinoma. Am J Surg, 189, 707-13.
  21. Moertel CG, Fleming TR, Macdonald JS, et al (1993). Haller DG, Laurie JA, Tangen C. An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer. JAMA, 270, 943-7.
  22. Nelson H, Petrelli N, Carlin A, et al (2001). Couture J, Fleshman J, Guillem J, Miedema B, Ota D, Sargent D. Guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst, 93, 583-96.
  23. O'Connell MJ, Campbell ME, Goldberg RM, et al (2008). Survival following recurrence in stage II and III colon cancer: findings from the ACCENT data set. J Clin Oncol, 26, 2336-41.
  24. Tsai HL, Chu KS, Huang YH, et al (2009). Predictive factors of early relapse in UICC stage I-III colorectal cancer patients after curative resection. J Surg Oncol, 100, 736-43.
  25. Tsai HL, Yeh YS, Yu FJ, et al (2009). Predicting factors of postoperative relapse in T2-4N0M0 colorectal cancer patients via harvesting a minimum of 12 lymph nodes. Int J Colorectal Dis, 24, 177- 83.
  26. Tsai HL, Cheng KI, Lu CY, et al (2008). Prognostic significance of depth of invasion, vascular invasion and numbers of lymph node retrievals in combination for patients with stage II colorectal cancer undergoing radical resection. J Surg Oncol, 97, 383-7.
  27. Tsai HL, Lu CY, Hsieh JS, et al (2007). The prognostic significance of total lymph node harvest in patients with T2-4N0M0 colorectal cancer. J Gastrointest Surg, 11, 660-5.
  28. Van Cutsem E, Kohne CH, Hitre E, et al (2009).Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med, 360, 1408-17.
  29. Wang RJ, Wu P, Cai GX, et al (2014). Down-regulated MYH11 expression correlates with poor prognosis in stage II and III colorectal cancer. Asian Pac J Cancer Prev, 15, 7223-8
  30. Wolmark N, Rockette H, Fisher B, et al (1993). The benefit of leucovorin-modulated fluorouracil as postoperative adjuvant therapy for primary colon cancer: results from National Surgical Adjuvant Breast and Bowel Project protocol C-03. J Clin Oncol, 11, 1879-87
  31. Wu HW, Gao LD, Wei GH (2013). HMSH2 and nm23 expression in sporadic colorectal cancer and its clinical significance. Asian Pac J Cancer Prev, 14, 1995-8.

Cited by

  1. Colorectal Cancer Patient Characteristics, Treatment and Survival in Oman - a Single Center Study vol.16, pp.12, 2015,
  2. Diet and Colorectal Cancer Risk in Asia - a Systematic Review vol.16, pp.13, 2015,
  3. microRNA Expression Profile in Patients with Stage II Colorectal Cancer: A Turkish Referral Center Study vol.16, pp.5, 2015,
  4. Prognostic Factors and the Role of Adjuvant Chemotherapy in Post-curative Surgery for Dukes B and C Colon Cancers and Survival Outcomes: a Malaysian Experience vol.16, pp.6, 2015,
  5. Analyses of Multiple Factors for Determination of "Selected Patients" Who Should Receive Rechallenge Treatment in Metastatic Colorectal Cancer: a Retrospective Study from Turkey vol.16, pp.7, 2015,
  6. Factors Affecting Prognosis in Metastatic Colorectal Cancer Patients vol.16, pp.7, 2015,
  7. Melatonin as a treatment for gastrointestinal cancer: a review vol.58, pp.4, 2015,
  8. Molecular correlates and prognostic value of tmTNF-α expression in colorectal cancer of 5-Fluorouracil-Based Adjuvant Therapy vol.17, pp.6, 2016,