Reduced risk of colorectal cancer recurrence after surgery

Top line:

With the improvement of colorectal cancer Survival and recurrence rates after (CRC) surgery have also decreased significantly over the past 20 years.

methodology:

• Advances over the past 20 years have improved survival rates for colorectal cancer, but it is unclear whether these advances have reduced the risk of recurrence after surgery.

• To find out, researchers used a national database to examine the outcomes of 34,166 Danish patients with stage I-III colorectal cancer after curative-intent surgery.

• The researchers divided patients into three treatment periods: 2004-2008, 2009-2013, and 2014-2019, and evaluated recurrence rates and time from surgery to recurrence.

• In 2014, Denmark launched a nationwide colorectal cancer screening program using a fecal immunochemical test for people aged 50 to 74.

remove:

• Overall, the 5-year cumulative recurrence rate decreased from 26.9% in 2004-2008 to 15.8% in 2014-2019, and the time from surgery to recurrence decreased from 1 year in 2004-2008 to 3 in 2014-2019. It reached its peak in the year.

• for colon cancerthe 5-year cumulative recurrence rate decreased from 16.3% to 6.8% for stage I disease, from 21.9% to 11.6% for stage II disease, and from 35.3% to 24.6% for stage III disease over the treatment period.

• for rectal cancerthe 5-year cumulative incidence decreased from 19.9% ​​to 9.5% for stage I disease, from 25.8% to 18.4% for stage II disease, and from 38.7% to 28.8% for stage III disease.

• Across all stages, screen-detected colorectal cancers had cumulative recurrence rates that were 24% to 35% lower than clinically detected cancers.

in fact:

“The results of this study demonstrate a significant and sustained reduction in colorectal cancer recurrence rates from 2004 to 2019,” the authors concluded.

As survival rates improve and recurrence rates decline, future studies should consider moving from one-size-fits-all postoperative monitoring to a more individualized approach based on recurrence risk. . The authors conclude, “The risk of colorectal cancer recurrence is so low in selected patient groups that less intensive surveillance, or no surveillance at all, may be noninferior to current guidelines.” I think there is,” he said.

sauce:

The study, led by Jesper Nors, MD, of Aarhus University, Denmark, was published on November 16th. JAMA Oncology.

Limitations:

The review was limited to one Scandinavian country. This study did not address the relative importance of screening and treatment in reducing colorectal cancer recurrence.

Disclosure:

The research was funded by Aarhus University, Novo Nordisk and others. Study co-author Dr. Klaus Lindbjorg Andersen reported that during the study period, Novo received grants from the Nordisk Foundation, the Danish Innovation Fund, and the Danish Cancer Society. No other disclosures were reported.

M. Alexander Otto is a physician assistant who earned a master’s degree in medicine and a degree in journalism from Newhouse. He is an award-winning medical journalist who worked for several major news organizations before joining Medscape. Alex is also an MIT Knight Fellow in Science Journalism. Email: aotto@mdedge.com