Long-term follow-up and survivorship after completing systematic surveillance in stage I–III colorectal cancer: who is still at risk?
Veen, Torhild; Stormark, Kjartan; Nedrebø, Bjørn Steinar Olden; Berg, Marianne; Søreide, Jon Arne; Kørner, Hartwig; Søreide, Kjetil
Original version
Veen, T. et al. (2015) Long-term follow-up and survivorship after completing systematic surveillance in stage I–III colorectal cancer: who is still at risk? Journal of Gastrointestinal Cancer, 46(3):259-266 10.1007/s12029-015-9723-2Abstract
Purpose
In patients with a high life expectancy at the time of
surgery for colorectal cancer (CRC), the long-term outcome
may be influenced by factors other than their cancer. We
aimed to investigate the long-term outcome and cause of death
beyond a 5-year surveillance programme.
Methods
We evaluated the overall survival (OS) and cancer-
specific survival (CSS) of a population-based cohort of stage
I – III CRC patients <75 years old who completed a systematic
surveillance programme.
Results
In total, 161 patients <75 years old, 111 (69 %) of
whom were node negative (pN0), were included. The median
follow-up time was 12.1 years. The OS was 54 % at 15 years
and differed significantly between the pN0 and pN+ patients
(65 vs. 30 %;
P
<0.001); CSS (72 %) also differed between the
pN0 and pN+ patients (85 vs. 44 %;
P
<0.001). For the 5-year
survivors (n=119), 14 (12 %) died of CRC during additional
long-term follow-up (7 each for pN0 and pN+), and 6 patients
(5 %; all pN0) died of other cancers. Patients aged <65 years
exhibited better long-term survival (81 %), but most of the
deaths were due to CRC (10/12 deaths). Only two of the 14 cancer-related deaths involved microsatellite instable (MSI)
CRC. Females exhibited better OS and CSS beyond 5 years
of surveillance.
Conclusions
The long-term survival beyond 5-year survivor-
ship for stage I – III CRC is very good. Nonetheless, cancer-
related deaths are encountered in one-third of patients and
occur most frequently in patients who are <65 years old at
disease onset — pointing to a still persistent risk several years
after surgery
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