TY - JOUR
T1 - Identification of high-risk stage I colon and rectal cancer patients
T2 - a retrospective analysis of a large Japanese cohort
AU - Japanese Study Group for Postoperative Follow-up of Colorectal Cancer
AU - Fukui, Yudai
AU - Hida, Koya
AU - Hoshino, Nobuaki
AU - Nishizaki, Daisuke
AU - Okamura, Ryosuke
AU - Yamauchi, Shinichi
AU - Sugihara, Kenichi
AU - Sakai, Yoshiharu
AU - Takemasa, I.
AU - Hakamada, K.
AU - Kameyama, H.
AU - Takii, Y.
AU - Ueno, H.
AU - Ozawa, H.
AU - Ishihara, S.
AU - Takahashi, K.
AU - Kanemitsu, Y.
AU - Itabashi, M.
AU - Kiyomatsu, T.
AU - Kinugasa, Y.
AU - Okabayashi, K.
AU - Hashiguchi, Y.
AU - Masaki, T.
AU - Watanabe, M.
AU - Shiomi, A.
AU - Hanai, T.
AU - Komori, K.
AU - Ohue, M.
AU - Noura, S.
AU - Tomita, N.
AU - Akagi, Y.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/6
Y1 - 2022/6
N2 - Purpose: Data regarding risk factors for recurrence in stage I colorectal cancer patients are limited. The aim of this study was to clarify the existence of a high-recurrence-risk population among stage I colorectal cancer patients. Methods: This analysis included 7,539 stage I colorectal cancer patients treated between 1997 and 2012 at 24 leading hospitals in Japan. Risk factors for time to recurrence were evaluated using a Cox proportional hazards model, and a high-risk group for recurrence was identified. Prognostic outcomes of high-risk stage I colorectal cancer patients were compared with those of low-risk stage I and stage II patients. Results: Multivariable analyses identified left-sided location (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.09–2.58), T2 tumors (HR: 1.80, 95% CI: 1.21–2.66), and lymphatic invasion (HR: 1.55, 95% CI: 1.05–2.28) as risk factors for recurrence in stage I colon cancer, and patients with these three risk factors were classified as high risk. For stage I rectal cancer, patients with poor differentiation (HR: 2.86, 95% CI: 1.21–5.69), T2 tumors (HR: 1.53, 95% CI: 1.07–2.23), and venous invasion (HR: 1.51, 95% CI: 1.08–2.13) were identified as high risk. The Kaplan–Meier analysis of cumulative recurrence rate and recurrence-free survival revealed that the high-risk stage I colorectal cancer patients have poorer clinical outcomes than the low-risk patients. Conclusion: Although stage I colorectal cancer patients generally have a favorable prognosis after curative surgery, poorer prognosis was observed in high-risk stage I colorectal cancer patients than in low-risk patients.
AB - Purpose: Data regarding risk factors for recurrence in stage I colorectal cancer patients are limited. The aim of this study was to clarify the existence of a high-recurrence-risk population among stage I colorectal cancer patients. Methods: This analysis included 7,539 stage I colorectal cancer patients treated between 1997 and 2012 at 24 leading hospitals in Japan. Risk factors for time to recurrence were evaluated using a Cox proportional hazards model, and a high-risk group for recurrence was identified. Prognostic outcomes of high-risk stage I colorectal cancer patients were compared with those of low-risk stage I and stage II patients. Results: Multivariable analyses identified left-sided location (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.09–2.58), T2 tumors (HR: 1.80, 95% CI: 1.21–2.66), and lymphatic invasion (HR: 1.55, 95% CI: 1.05–2.28) as risk factors for recurrence in stage I colon cancer, and patients with these three risk factors were classified as high risk. For stage I rectal cancer, patients with poor differentiation (HR: 2.86, 95% CI: 1.21–5.69), T2 tumors (HR: 1.53, 95% CI: 1.07–2.23), and venous invasion (HR: 1.51, 95% CI: 1.08–2.13) were identified as high risk. The Kaplan–Meier analysis of cumulative recurrence rate and recurrence-free survival revealed that the high-risk stage I colorectal cancer patients have poorer clinical outcomes than the low-risk patients. Conclusion: Although stage I colorectal cancer patients generally have a favorable prognosis after curative surgery, poorer prognosis was observed in high-risk stage I colorectal cancer patients than in low-risk patients.
KW - Colorectal cancer
KW - High risk
KW - Recurrence
KW - Stage I
UR - http://www.scopus.com/inward/record.url?scp=85131701732&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85131701732&partnerID=8YFLogxK
U2 - 10.1007/s00384-022-04161-3
DO - 10.1007/s00384-022-04161-3
M3 - Article
C2 - 35588331
AN - SCOPUS:85131701732
SN - 0179-1958
VL - 37
SP - 1403
EP - 1410
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
IS - 6
ER -