Clinicopathological and Molecular Features of Patients with Early and Late Recurrence after Curative Surgery for Colorectal Cancer
by
, , ,
Yuan-Tzu Lan
1,2,*, 
Shih-Ching Chang
1,2,
Pei-Ching Lin
3,4,
Chun-Chi Lin
1,2,
Hung-Hsin Lin
1,2,
Sheng-Chieh Huang
1,2,
Chien-Hsing Lin
5,
Wen-Yi Liang
6,
Wei-Shone Chen
1,2,
Jeng-Kai Jiang
1,2,
Shung-Haur Yang
1,2,7 and
Jen-Kou Lin
1,2 1
Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan
2
Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
3
Department of Clinical Pathology, Yang-Ming Branch, Taipei City Hospital, Taipei 11146, Taiwan
4
Department of Health and Welfare, University of Taipei, Taipei 11153, Taiwan
5
Division of Genomic Medicine, National Health Research Institutes, Zhunan 35053, Taiwan
6
Department of Pathology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
7
Department of Surgery, National Yang Ming Chiao Tung University Hospital, Yilan 26058, Taiwan
*
Author to whom correspondence should be addressed.
Cancers 2021, 13(8), 1883; https://doi.org/10.3390/cancers13081883
Submission received: 5 March 2021
/
Revised: 10 April 2021
/
Accepted: 12 April 2021
/
Published: 14 April 2021
Simple Summary
Colorectal cancer patients with early recurrence had advanced pathological node categories, pathological tumor, node, metastasis stages, adjuvant chemotherapy treatment, a worse overall survival rate, more liver metastases and more APC mutations than those with late recurrence. Patients with right-sided colon cancer tended to have early recurrence than those with left-sided colon cancer or rectal cancer. The postrecurrence survival rates were not significantly different between patients with early and late recurrence, which was observed in right-sided colon, left-sided colon and rectum. Multivariate analysis showed that old age, early recurrence, multiple-site recurrence and BRAF and NRAS mutations were independent prognostic factors.
Abstract
Background: Few reports have investigated genetic alterations between patients with early and late recurrence following curative surgery for colorectal cancer (CRC). Methods: 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. Results: 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; APC 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 BRAF and NRAS mutations to be independent prognostic factors. Conclusion: CRC patients with early recurrence have a worse OS rate and more APC mutations than those with late recurrence.
