Lan Yuan-Tzu, Chang Shih-Ching, Lin Pei-Ching, Lin Chun-Chi, Lin Hung-Hsin, Huang Sheng-Chieh, Lin Chien-Hsing, Liang Wen-Yi, Chen Wei-Shone, Jiang Jeng-Kai, Yang Shung-Haur, Lin Jen-Kou
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
Cancers (Basel). 2021 Apr 14;13(8):1883. doi: 10.3390/cancers13081883.
Few reports have investigated genetic alterations between patients with early and late recurrence following curative surgery for colorectal cancer (CRC).
A total of 1227 stage I-III CRC patients who underwent curative resection were included retrospectively. Among them, 236 patients had tumor recurrence: 139 had early (<2 years after surgery) and 97 had late (≥2 years after surgery) recurrence. Clinicopathological features and genetic alterations were compared between the two groups.
Compared to those with late recurrence, patients with early recurrence were more likely to have advanced pathological node (N) categories; tumor, node, metastasis (TNM) stages; adjuvant chemotherapy treatment; liver metastases; mutations; and worse five-year overall survival rates. Patients with right-sided colon cancer were more likely to develop early recurrence than were those with left-sided colon cancer or rectal cancer. Regarding rectal cancer, patients with early recurrence were more likely to be at advanced pathological N categories and TNM stages than those with late recurrence. Multivariate analysis revealed old age, early recurrence, multiple-site recurrence, and and mutations to be independent prognostic factors.
CRC patients with early recurrence have a worse OS rate and more mutations than those with late recurrence.
很少有报告研究结直肠癌（CRC）根治性手术后早期和晚期复发患者之间的基因改变。
回顾性纳入1227例行根治性切除的I-III期CRC患者。其中，236例患者出现肿瘤复发：139例为早期复发（术后<2年），97例为晚期复发（术后≥2年）。比较两组患者的临床病理特征和基因改变。
与晚期复发患者相比，早期复发患者更有可能具有晚期病理淋巴结（N）分类、肿瘤、淋巴结、转移（TNM）分期、辅助化疗治疗、肝转移、 突变以及更差的五年总生存率。右侧结肠癌患者比左侧结肠癌或直肠癌患者更易发生早期复发。对于直肠癌，早期复发患者比晚期复发患者更有可能处于晚期病理N分类和TNM分期。多因素分析显示年龄较大、早期复发、多部位复发以及 和 突变是独立的预后因素。
与晚期复发的CRC患者相比，早期复发患者的总生存率更差且 突变更多。
