Digestive Cancer Registry of Burgundy F-21079, INSERM U866, CHU Dijon, University of Burgundy, France.
Digestive Tumour Registry of Calvados F-14000, CHU Caen, U1086 INSERM, Cancers and Preventions, France.
Int J Cancer. 2015 Nov 1;137(9):2133-8. doi: 10.1002/ijc.29578. Epub 2015 May 6.
Long-term recurrences of colon cancer raised questions about the possible benefit of prolonging the recommended active 5-year surveillance. The aim of this study was to determine, for the first time, the incidence and patterns of late 10-year recurrence following curative resection of colon cancer. Data were obtained from two French digestive cancer registries. A total of 3,622 patients under 85 years resected for cure for colon cancer diagnosed between 1985 and 2000 were included. Information regarding recurrences was actively collected. Cumulative failure rates at 10 years were estimated using Kaplan-Meier estimates corrected by cause-specific hazards, and multivariable analysis was performed using a model for the subdistribution of a competing risk proposed by Fine and Gray. The overall cumulative recurrence rate between 5 and 10 years after initial surgery was 2.9% for local recurrence and 4.3% for distant metastasis. Among men with no recurrence 5 years after diagnosis of colon cancer, 1 in 12 developed a recurrence between 5 and 10 years, and the corresponding cumulative rate was 7.8%. The frequency was 1 in 19 for women, corresponding to a cumulative rate of 5.2%. In the multivariate analysis, non-emergency diagnostic feature, female sex and age under 75 were associated with a lower risk of recurrence. Stage at diagnosis was not a predictor of late recurrence. Late recurrence after colon cancer resection with curative intent can occur. A regular clinical follow-up is necessary to detect early signs of possible recurrence.
结肠癌的长期复发引发了人们对于延长推荐的 5 年主动监测时间是否可能获益的疑问。本研究旨在首次确定结肠癌根治性切除术后 10 年晚期复发的发生率和模式。数据来自两个法国消化癌症登记处。共纳入 3622 名年龄在 85 岁以下的结肠癌患者，这些患者均在 1985 年至 2000 年间接受了根治性切除术。积极收集了有关复发的信息。使用 Kaplan-Meier 估计值和 Fine 和 Gray 提出的竞争风险亚分布模型进行多变量分析，校正了特定病因的风险。在初始手术后 5 至 10 年内，局部复发的总累积复发率为 2.9%，远处转移的累积复发率为 4.3%。在诊断为结肠癌 5 年后无复发的男性中，每 12 人中有 1 人在 5 至 10 年内复发，累积率为 7.8%。女性为 19 分之一，累积率为 5.2%。在多变量分析中，非紧急诊断特征、女性和年龄小于 75 岁与较低的复发风险相关。诊断时的分期不是晚期复发的预测因素。根治性切除术后结肠癌的晚期复发可能发生。需要定期进行临床随访以检测可能复发的早期迹象。
