Abstract
AIM: This study aimed to investigate the prognosis after recurrence in patients with stage I-III colon cancer (CC) and rectal cancer (RC). METHODS: Cancer recurred in 116 (15.2%) out of 763 patients with stage I-III colorectal cancer. The overall survival (OS) after recurrence was evaluated based on the recurrence organs and patterns. RESULTS: The first recurrence occurred in the lungs, livers, lymph nodes, and other sites in 32, 22, 12, and 2 patients, respectively. It was localized, disseminated, and involved two or more organs in 14, 9, and 25 patients, respectively. Patients with CC had a shorter OS after recurrence as compared to those with RC (P = .0103). Compared to other organ metastasis, liver metastasis was associated with an earlier recurrence (P = .0026) and shorter OS after recurrence (hazard ratio [HR]: 2.216; 95% confidence interval [CI]: 1.052-4.459; P = .0370). Lung metastasis was associated with a more favorable prognosis as compared to other organ recurrences (HR: 0.338; 95% CI: 0.135-0.741; P = .0057). One-organ recurrence and oligometastasis were observed in 78.4% and 49.1% of the patients, respectively. The 5-y OS rates of patients with one-organ recurrence and oligometastasis were 47.5% and 71.7%, respectively. Invasive treatment was associated with a favorable prognosis (P < .0001). CONCLUSIONS: Liver metastasis and dissemination were associated with a shorter OS after recurrence. Approximately 50% of the patients experienced oligometastasis, which was associated with a favorable prognosis. Hence, to improve patient prognosis it is better to perform invasive treatments when possible.