Long-Term Follow-Up and Survivorship After Completing Systematic Surveillance in Stage I–III Colorectal Cancer: Who Is Still at RiskReport as inadecuate




Long-Term Follow-Up and Survivorship After Completing Systematic Surveillance in Stage I–III Colorectal Cancer: Who Is Still at Risk - Download this document for free, or read online. Document in PDF available to download.

Journal of Gastrointestinal Cancer

, Volume 46, Issue 3, pp 259–266

First Online: 28 April 2015DOI: 10.1007-s12029-015-9723-2

Cite this article as: Veen, T., Stormark, K., Nedrebø, B.S. et al. J Gastrointest Canc 2015 46: 259. doi:10.1007-s12029-015-9723-2

Abstract

PurposeIn patients with a high life expectancy at the time of surgery for colorectal cancer CRC, the long-term outcome may be influenced by factors other than their cancer. We aimed to investigate the long-term outcome and cause of death beyond a 5-year surveillance programme.

MethodsWe evaluated the overall survival OS and cancer-specific survival CSS of a population-based cohort of stage I–III CRC patients <75 years old who completed a systematic surveillance programme.

ResultsIn total, 161 patients <75 years old, 111 69 % of whom were node negative pN0, were included. The median follow-up time was 12.1 years. The OS was 54 % at 15 years and differed significantly between the pN0 and pN+ patients 65 vs. 30 %; P < 0.001; CSS 72 % also differed between the pN0 and pN+ patients 85 vs. 44 %; P < 0.001. For the 5-year survivors n = 119, 14 12 % died of CRC during additional long-term follow-up 7 each for pN0 and pN+, and 6 patients 5 %; all pN0 died of other cancers. Patients aged <65 years exhibited better long-term survival 81 %, but most of the deaths were due to CRC 10-12 deaths. Only two of the 14 cancer-related deaths involved microsatellite instable MSI CRC. Females exhibited better OS and CSS beyond 5 years of surveillance.

ConclusionsThe long-term survival beyond 5-year survivorship for stage I–III CRC is very good. Nonetheless, cancer-related deaths are encountered in one-third of patients and occur most frequently in patients who are <65 years old at disease onset—pointing to a still persistent risk several years after surgery.

KeywordsColorectal cancer Survival Long-term follow-up Surveillance Recurrence Microsatellite instability AbbreviationsOSOverall survival

CSSCancer-specific survival

CRCColorectal cancer

ASAAmerican Society of Anesthesiologists score

MSIMicrosatellite instability

CEACarcinoembryonic antigen

TNMTumour-node-metastasis stage

NGICGNorwegian Gastrointestinal Cancer Group

Presented in

Abstract form at the International Surgical Week 25–29 August 2013 in Helsinki, Finland, and the Surgical Week of the Norwegian Surgical Association, October 2014 in Oslo, Norway.

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Author: T. Veen - K. Stormark - B. S. Nedrebø - M. Berg - J. A. Søreide - H. Kørner - Kjetil Søreide

Source: https://link.springer.com/



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