Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group
Objective:. The aim of this study is to provide solid evidence to update the management of stage I colon cancer (CC) after surgery. Background:. Given the low risk of recurrence of stage I CC, some international guidelines do not recommend intensive follow-up after surgery. However, data on the actu...
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Wolters Kluwer Health
2024-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000510 |
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| author | Giulia Turri, MD Luigi Martinelli, MD Daniela Rega, MD Nicolò Tamini, MD Lucia Paiano, MD Simona Deidda, MD QuocRiccardo Bao, MD Laura Lorenzon, MD, PhD Raffaele De Luca, MD Caterina Foppa, MD, PhD Valentina Mari, MD Giovanni Taffurelli, MD Arcangelo Picciariello, MD, PhD Patrizia Marsanic, MD Leandro Siragusa, MD Francesco Bagolini, MD Riccardo Nascimbeni, MD Gianluca Rizzo, MD, PhD Sara Vertaldi, MD Michele Zuolo, MD Giorgio Bianchi, MD Lisa Marie Rorato, MD Rossella Reddavid, MD, PhD Gaetano Gallo, MD, PhD Lorenzo Crepaz, MD Alberto Di Leo, MD Mario Trompetto, MD Enrico Potenza, MD Mauro Santarelli, MD Nicola de’Angelis, MD, PhD Francesco Ciarleglio, MD Marco Milone, MD, PhD Claudio Coco, MD Guido Alberto Tiberio, MD Gabriele Anania, MD Giuseppe S. Sica, MD, PhD Andrea Muratore, MD Donato Francesco Altomare, MD Isacco Montroni, MD, PhD Maurizio De Luca, MD Antonino Spinelli, MD, PhD Michele Simone, MD Roberto Persiani, MD Gaya Spolverato, MD Angelo Restivo, MD Nicolò de Manzini, MD Marco Braga, MD Paolo Delrio, MD Giuseppe Verlato, MD, PhD Corrado Pedrazzani, MD Adriana Gioia Cristina Vacca Dario Parini Giovanni Tomasicchio Marcello Calabrò Bruno Sensi Filomena Misuriello Carlo Alberto Schena Silvia Picotto |
| author_facet | Giulia Turri, MD Luigi Martinelli, MD Daniela Rega, MD Nicolò Tamini, MD Lucia Paiano, MD Simona Deidda, MD QuocRiccardo Bao, MD Laura Lorenzon, MD, PhD Raffaele De Luca, MD Caterina Foppa, MD, PhD Valentina Mari, MD Giovanni Taffurelli, MD Arcangelo Picciariello, MD, PhD Patrizia Marsanic, MD Leandro Siragusa, MD Francesco Bagolini, MD Riccardo Nascimbeni, MD Gianluca Rizzo, MD, PhD Sara Vertaldi, MD Michele Zuolo, MD Giorgio Bianchi, MD Lisa Marie Rorato, MD Rossella Reddavid, MD, PhD Gaetano Gallo, MD, PhD Lorenzo Crepaz, MD Alberto Di Leo, MD Mario Trompetto, MD Enrico Potenza, MD Mauro Santarelli, MD Nicola de’Angelis, MD, PhD Francesco Ciarleglio, MD Marco Milone, MD, PhD Claudio Coco, MD Guido Alberto Tiberio, MD Gabriele Anania, MD Giuseppe S. Sica, MD, PhD Andrea Muratore, MD Donato Francesco Altomare, MD Isacco Montroni, MD, PhD Maurizio De Luca, MD Antonino Spinelli, MD, PhD Michele Simone, MD Roberto Persiani, MD Gaya Spolverato, MD Angelo Restivo, MD Nicolò de Manzini, MD Marco Braga, MD Paolo Delrio, MD Giuseppe Verlato, MD, PhD Corrado Pedrazzani, MD Adriana Gioia Cristina Vacca Dario Parini Giovanni Tomasicchio Marcello Calabrò Bruno Sensi Filomena Misuriello Carlo Alberto Schena Silvia Picotto |
| author_sort | Giulia Turri, MD |
| collection | DOAJ |
| description | Objective:. The aim of this study is to provide solid evidence to update the management of stage I colon cancer (CC) after surgery.
Background:. Given the low risk of recurrence of stage I CC, some international guidelines do not recommend intensive follow-up after surgery. However, data on the actual incidence, risk factors, and site of recurrences are scarce.
Methods:. This is a retrospective multicenter cohort study considering patients who underwent surgery at 25 Italian centers between 2010 and 2019, with a minimum follow-up of 24 months. A total of 1883 consecutive adult patients with stage I CC treated with curative surgery were considered, and 1611 fulfilled the inclusion criteria. The primary outcome was the rate of recurrence. Secondary outcomes included survival and risk factors for recurrence.
Results:. Eighty patients developed cancer recurrence (5.0%), of which 90% was systemic relapse. The event was more frequent in pT2 (6.0% vs 3.2%, P = 0.013), male patients (6.1% vs 3.6%, P = 0.021), in the presence of lymphovascular invasion (7.2% vs 3.6%, P = 0.01), and in cases of partial resection (11.1% vs 4.6%, P = 0.011). Also, preoperative carcinoembryonic antigen (P = 0.007) and tumor diameter (P < 0.001) were higher in the group who relapsed. Most patients had isolated cancer recurrence (90%). Recurrences peaked between 10 and 18 months after surgery and declined over time. Adjusted Cox regression analysis identified tumor diameter, carcinoembryonic antigen level, lymphovascular invasion, male gender, and less than 12 analyzed lymph nodes as significant risk factors for worse recurrence-free survival.
Conclusions:. This study showed that a not negligible rate of stage I CC recur after curative surgery. Most relapses occur at a single site within the first 3 years after surgery. This evidence could be used to optimize postoperative follow-up. |
| format | Article |
| id | doaj-art-8805ed0a1ecc4566a6f560a541ee6cea |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-8805ed0a1ecc4566a6f560a541ee6cea2025-01-24T09:18:58ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-12-0154e51010.1097/AS9.0000000000000510202412000-00027Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative GroupGiulia Turri, MD0Luigi Martinelli, MD1Daniela Rega, MD2Nicolò Tamini, MD3Lucia Paiano, MD4Simona Deidda, MD5QuocRiccardo Bao, MD6Laura Lorenzon, MD, PhD7Raffaele De Luca, MD8Caterina Foppa, MD, PhD9Valentina Mari, MD10Giovanni Taffurelli, MD11Arcangelo Picciariello, MD, PhD12Patrizia Marsanic, MD13Leandro Siragusa, MD14Francesco Bagolini, MD15Riccardo Nascimbeni, MD16Gianluca Rizzo, MD, PhD17Sara Vertaldi, MD18Michele Zuolo, MD19Giorgio Bianchi, MD20Lisa Marie Rorato, MD21Rossella Reddavid, MD, PhD22Gaetano Gallo, MD, PhD23Lorenzo Crepaz, MD24Alberto Di Leo, MD25Mario Trompetto, MD26Enrico Potenza, MD27Mauro Santarelli, MD28Nicola de’Angelis, MD, PhD29Francesco Ciarleglio, MD30Marco Milone, MD, PhD31Claudio Coco, MD32Guido Alberto Tiberio, MD33Gabriele Anania, MD34Giuseppe S. Sica, MD, PhD35Andrea Muratore, MD36Donato Francesco Altomare, MD37Isacco Montroni, MD, PhD38Maurizio De Luca, MD39Antonino Spinelli, MD, PhD40Michele Simone, MD41Roberto Persiani, MD42Gaya Spolverato, MD43Angelo Restivo, MD44Nicolò de Manzini, MD45Marco Braga, MD46Paolo Delrio, MD47Giuseppe Verlato, MD, PhD48Corrado Pedrazzani, MD49Adriana GioiaCristina VaccaDario PariniGiovanni TomasicchioMarcello CalabròBruno SensiFilomena MisurielloCarlo Alberto SchenaSilvia PicottoFrom the * Chirurgia Generale ed Epatobiliare, Azienda Ospedaliera Universitaria Integrata di Verona, Università degli Studi di Verona, Verona, Italy† Department of Diagnostic and Public Health, University of Verona, Verona, Italy‡ Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, “Fondazione G. Pascale” IRCSS, Naples, Italy§ Chirurgia Generale, IRCCS San Gerardo Monza, Università Milano Bicocca, Milano, Italy‖ UCO Clinica Chirurgica, Università di Trieste, Trieste, Italy¶ UOC Chirurgia Coloproctologica, AOU Cagliari, Cagliari, Italy# Chirurgia Generale 3, Azienda Ospedaliera Universitaria Integrata di Padova, Padova, Italy** UOC Chirurgia Generale 1, Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Roma, Italy†† Department of Surgical Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy‡‡ Department of Biomedical Sciences, Humanitas University, Milan, Italy‖‖ Chirurgia Generale, Ospedale Santa Maria della Misericordia, Rovigo, Italy¶¶ Chirurgia Colorettale, Ospedale Santa Maria delle Croci, Ravenna, Italy## Department of Experimental Medicine, University of Salento, Lecce, Italy*** S.C. Chirurgia, Ospedale E. Agnelli, ASL TO 3, Presidio Pinerolo, Italy††† Minimally Invasive and Gastrointestinal Surgery Unit, Department of General Surgery, University of Rome Tor Vergata, Rome, Italy‡‡‡ Chirurgia 1, Ospedale di Cona, Azienda Ospedaliera Universitaria Integrata di Ferrara, Ferrara, Italy§§§ Clinica Chirurgica, Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy‖‖‖ UOC Chirurgia Digestiva e del Colon-Retto - Ospedale Isola Tiberina Gemelli Isola, Roma, Italy¶¶¶ Chirurgia Endoscopica, AOUI Federico II Napoli, Napoli, Italy### APSS, Azienda Provinciale per i Servizi Sanitari, UO di Chirurgia Generale, Ospedale Valli del Noce, Trento, Italy**** Unit of Digestive and HPB Surgery, Henri Mordor University Hospital, Paris, France†††† Chirurgia d’Urgenza e PS 3, AOU Città della Salute e della Scienza, Torino, Italy‡‡‡‡ Division of Surgical Oncology and Digestive Surgery, Department of Oncology, University of Turin, San Luigi University Hospital, Turin, Italy§§§§ Unità di Chirurgia Colorettale, Clinica Santa Rita, Vercelli, Italy¶¶¶¶ Chirurgia Generale e Mininvasiva, Ospedale San Camillo, Trento, Italy¶¶¶¶ Chirurgia Generale e Mininvasiva, Ospedale San Camillo, Trento, Italy§§§§ Unità di Chirurgia Colorettale, Clinica Santa Rita, Vercelli, Italy‡‡‡‡ Division of Surgical Oncology and Digestive Surgery, Department of Oncology, University of Turin, San Luigi University Hospital, Turin, Italy†††† Chirurgia d’Urgenza e PS 3, AOU Città della Salute e della Scienza, Torino, Italy**** Unit of Digestive and HPB Surgery, Henri Mordor University Hospital, Paris, France### APSS, Azienda Provinciale per i Servizi Sanitari, UO di Chirurgia Generale, Ospedale Valli del Noce, Trento, Italy¶¶¶ Chirurgia Endoscopica, AOUI Federico II Napoli, Napoli, Italy#### Chirurgia Generale 2, Fondazione Policlinico Universitario “A.Gemelli”, IRCCS Roma, Italy§§§ Clinica Chirurgica, Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy‡‡‡ Chirurgia 1, Ospedale di Cona, Azienda Ospedaliera Universitaria Integrata di Ferrara, Ferrara, Italy††† Minimally Invasive and Gastrointestinal Surgery Unit, Department of General Surgery, University of Rome Tor Vergata, Rome, Italy*** S.C. Chirurgia, Ospedale E. Agnelli, ASL TO 3, Presidio Pinerolo, Italy***** Dipartimento di Medicina di Precisione e Rigenerativa e Polo Jonico (DiMePRE-J), Università degli Studi Aldo Moro di Bari, Bari, Italy.¶¶ Chirurgia Colorettale, Ospedale Santa Maria delle Croci, Ravenna, Italy‖‖ Chirurgia Generale, Ospedale Santa Maria della Misericordia, Rovigo, Italy‡‡ Department of Biomedical Sciences, Humanitas University, Milan, Italy†† Department of Surgical Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy** UOC Chirurgia Generale 1, Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Roma, Italy# Chirurgia Generale 3, Azienda Ospedaliera Universitaria Integrata di Padova, Padova, Italy¶ UOC Chirurgia Coloproctologica, AOU Cagliari, Cagliari, Italy‖ UCO Clinica Chirurgica, Università di Trieste, Trieste, Italy§ Chirurgia Generale, IRCCS San Gerardo Monza, Università Milano Bicocca, Milano, Italy‡ Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, “Fondazione G. Pascale” IRCSS, Naples, Italy† Department of Diagnostic and Public Health, University of Verona, Verona, ItalyFrom the * Chirurgia Generale ed Epatobiliare, Azienda Ospedaliera Universitaria Integrata di Verona, Università degli Studi di Verona, Verona, ItalyObjective:. The aim of this study is to provide solid evidence to update the management of stage I colon cancer (CC) after surgery. Background:. Given the low risk of recurrence of stage I CC, some international guidelines do not recommend intensive follow-up after surgery. However, data on the actual incidence, risk factors, and site of recurrences are scarce. Methods:. This is a retrospective multicenter cohort study considering patients who underwent surgery at 25 Italian centers between 2010 and 2019, with a minimum follow-up of 24 months. A total of 1883 consecutive adult patients with stage I CC treated with curative surgery were considered, and 1611 fulfilled the inclusion criteria. The primary outcome was the rate of recurrence. Secondary outcomes included survival and risk factors for recurrence. Results:. Eighty patients developed cancer recurrence (5.0%), of which 90% was systemic relapse. The event was more frequent in pT2 (6.0% vs 3.2%, P = 0.013), male patients (6.1% vs 3.6%, P = 0.021), in the presence of lymphovascular invasion (7.2% vs 3.6%, P = 0.01), and in cases of partial resection (11.1% vs 4.6%, P = 0.011). Also, preoperative carcinoembryonic antigen (P = 0.007) and tumor diameter (P < 0.001) were higher in the group who relapsed. Most patients had isolated cancer recurrence (90%). Recurrences peaked between 10 and 18 months after surgery and declined over time. Adjusted Cox regression analysis identified tumor diameter, carcinoembryonic antigen level, lymphovascular invasion, male gender, and less than 12 analyzed lymph nodes as significant risk factors for worse recurrence-free survival. Conclusions:. This study showed that a not negligible rate of stage I CC recur after curative surgery. Most relapses occur at a single site within the first 3 years after surgery. This evidence could be used to optimize postoperative follow-up.http://journals.lww.com/10.1097/AS9.0000000000000510 |
| spellingShingle | Giulia Turri, MD Luigi Martinelli, MD Daniela Rega, MD Nicolò Tamini, MD Lucia Paiano, MD Simona Deidda, MD QuocRiccardo Bao, MD Laura Lorenzon, MD, PhD Raffaele De Luca, MD Caterina Foppa, MD, PhD Valentina Mari, MD Giovanni Taffurelli, MD Arcangelo Picciariello, MD, PhD Patrizia Marsanic, MD Leandro Siragusa, MD Francesco Bagolini, MD Riccardo Nascimbeni, MD Gianluca Rizzo, MD, PhD Sara Vertaldi, MD Michele Zuolo, MD Giorgio Bianchi, MD Lisa Marie Rorato, MD Rossella Reddavid, MD, PhD Gaetano Gallo, MD, PhD Lorenzo Crepaz, MD Alberto Di Leo, MD Mario Trompetto, MD Enrico Potenza, MD Mauro Santarelli, MD Nicola de’Angelis, MD, PhD Francesco Ciarleglio, MD Marco Milone, MD, PhD Claudio Coco, MD Guido Alberto Tiberio, MD Gabriele Anania, MD Giuseppe S. Sica, MD, PhD Andrea Muratore, MD Donato Francesco Altomare, MD Isacco Montroni, MD, PhD Maurizio De Luca, MD Antonino Spinelli, MD, PhD Michele Simone, MD Roberto Persiani, MD Gaya Spolverato, MD Angelo Restivo, MD Nicolò de Manzini, MD Marco Braga, MD Paolo Delrio, MD Giuseppe Verlato, MD, PhD Corrado Pedrazzani, MD Adriana Gioia Cristina Vacca Dario Parini Giovanni Tomasicchio Marcello Calabrò Bruno Sensi Filomena Misuriello Carlo Alberto Schena Silvia Picotto Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group Annals of Surgery Open |
| title | Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group |
| title_full | Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group |
| title_fullStr | Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group |
| title_full_unstemmed | Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group |
| title_short | Predictors of Recurrence After Curative Surgery for Stage I Colon Cancer: Retrospective Cohort Analysis of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group |
| title_sort | predictors of recurrence after curative surgery for stage i colon cancer retrospective cohort analysis of the italian society of surgical oncology colorectal cancer network collaborative group |
| url | http://journals.lww.com/10.1097/AS9.0000000000000510 |
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