Ferreira Pinto Paula, Peyroteo Mariana, Baía Catarina, Marques Mariana, Cardoso Maria João, Videira José Flávio, Abreu de Sousa Joaquim
Surgical Oncology Department, Instituto Português de Oncologia do Porto, Porto, Portugal.
GE Port J Gastroenterol. 2024 Aug 16;32(2):109-117. doi: 10.1159/000540338. eCollection 2025 Apr.
Colorectal cancer is the third most prevalent cancer among both men and women with 80% of patients having localized disease enabling curative treatments. Given the low recurrence rate in early-stage disease, there is a growing interest in reviewing follow-up protocols. The aim of this study was to assess the frequency and timing of recurrence in early-stage colon cancer, as well as recurrence patterns.
The data from all patients with colon adenocarcinoma consecutively treated with surgery at the Instituto Português de Oncologia do Porto, EPE, between January 2013 and December 2016, were retrospectively reviewed.
A total of 1,372 patients with colon cancer were submitted to surgery during the study period. From this group, 51.4% ( = 705) were early-stage colon cancers. Regarding the pathological stage, 3.5% were stage 0, 37.4% were stage I and 59.1% were stage II. The overall recurrence rate was 6.7%. When considering the group of patients without risk factors, the recurrence rate was 5.6%. The majority of recurrences occurred in the first 3 years of follow-up. The recurrence was diagnosed in the majority of patients through carcinoembryonic antigen elevation, followed by imaging exams. The presence of one or more risk factors (high nuclear grade, vascular invasion, extramural venous invasion, and perineural invasion) showed a statistically significant association with recurrence rate.
The recurrence rate was low in early-stage colon cancer, with the majority of recurrences occurring in the first 3 years. Our study results show that surveillance should be tailored according to individual risk factors.
结直肠癌是男性和女性中第三大常见癌症，80%的患者患有局限性疾病，可行根治性治疗。鉴于早期疾病的复发率较低，人们对审查随访方案的兴趣与日俱增。本研究的目的是评估早期结肠癌复发的频率和时间，以及复发模式。
回顾性分析了2013年1月至2016年12月期间在葡萄牙波尔图肿瘤研究所连续接受手术治疗的所有结肠腺癌患者的数据。
在研究期间，共有1372例结肠癌患者接受了手术。其中，51.4%（n = 705）为早期结肠癌。在病理分期方面，0期占3.5%，I期占37.4%，II期占59.1%。总体复发率为6.7%。在无危险因素的患者组中，复发率为5.6%。大多数复发发生在随访的前3年。大多数患者通过癌胚抗原升高诊断复发，其次是影像学检查。存在一个或多个危险因素（高核分级、血管侵犯、壁外静脉侵犯和神经周围侵犯）与复发率具有统计学意义的关联。
早期结肠癌的复发率较低，大多数复发发生在头3年。我们的研究结果表明，应根据个体危险因素进行监测。
