Patterns of metachronous metastases after curative treatment of colorectal cancer

Yvette R B M van Gestel; Ignace H J T de Hingh; Myrthe P P van Herk-Sukel; Felice N van Erning; Laurens V Beerepoot; Jan H Wijsman; Gerrit D Slooter; Harm J T Rutten; Geert-Jan M Creemers; Valery E P P Lemmens

doi:10.1016/j.canep.2014.04.004

Patterns of metachronous metastases after curative treatment of colorectal cancer

Yvette R B M van Gestel, Ignace H J T de Hingh, Myrthe P P van Herk-Sukel, Felice N van Erning, Laurens V Beerepoot, Jan H Wijsman, Gerrit D Slooter, Harm J T Rutten, Geert-Jan M Creemers, Valery E P P Lemmens

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: This study aimed to provide information on timing, anatomical location, and predictors for metachronous metastases of colorectal cancer based on a large consecutive series of non-selected patients.

METHODS: All patients operated on with curative intent for colorectal cancer (TanyNanyM0) between 2003 and 2008 in the Dutch Eindhoven Cancer Registry were included (N=5671). By means of active follow-up by the Cancer Registry staff within ten hospitals, data on development of metastatic disease were collected. Median follow-up was 5.0 years.

RESULTS: Of the 5671 colorectal cancer patients, 1042 (18%) were diagnosed with metachronous metastases. Most common affected sites were the liver (60%), lungs (39%), extra-regional lymph nodes (22%), and peritoneum (19%). 86% of all metastases was diagnosed within three years and the median time to diagnosis was 17 months (interquartile range 10-29 months). Male gender (HR=1.2, 95%CI 1.03-1.32), an advanced primary T-stage (T4 vs. T3 HR=1.6, 95%CI 1.32-1.90) and N-stage (N1 vs. N0 HR=2.8, 95%CI 2.42-3.30 and N2 vs. N0 HR=4.5, 95%CI 3.72-5.42), high-grade tumour differentiation (HR=1.4, 95%CI 1.17-1.62), and a positive (HR=2.1, 95%CI 1.68-2.71) and unknown (HR=1.7, 95%CI 1.34-2.22) resection margin were predictors for metachronous metastases.

CONCLUSIONS: Different patterns of metastatic spread were observed for colon and rectal cancer patients and differences in time to diagnosis were found. Knowledge on these patterns and predictors for metachronous metastases may enhance tailor-made follow-up schemes leading to earlier detection of metastasized disease and increased curative treatment options.

Original language	English
Pages (from-to)	448-54
Number of pages	7
Journal	Cancer Epidemiology
Volume	38
Issue number	4
DOIs	https://doi.org/10.1016/j.canep.2014.04.004
Publication status	Published - Aug 2014
Externally published	Yes

Keywords

Adenocarcinoma
Adult
Aged
Aged, 80 and over
Colorectal Neoplasms
Female
Humans
Male
Middle Aged
Neoplasm Metastasis
Proportional Hazards Models
Registries
Journal Article
Research Support, Non-U.S. Gov't

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10.1016/j.canep.2014.04.004

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van Gestel, Y. R. B. M., de Hingh, I. H. J. T., van Herk-Sukel, M. P. P., van Erning, F. N., Beerepoot, L. V., Wijsman, J. H., Slooter, G. D., Rutten, H. J. T., Creemers, G.-J. M., & Lemmens, V. E. P. P. (2014). Patterns of metachronous metastases after curative treatment of colorectal cancer. Cancer Epidemiology, 38(4), 448-54. https://doi.org/10.1016/j.canep.2014.04.004

@article{7036b29e928249128da855a1997deb8a,

title = "Patterns of metachronous metastases after curative treatment of colorectal cancer",

abstract = "BACKGROUND: This study aimed to provide information on timing, anatomical location, and predictors for metachronous metastases of colorectal cancer based on a large consecutive series of non-selected patients.METHODS: All patients operated on with curative intent for colorectal cancer (TanyNanyM0) between 2003 and 2008 in the Dutch Eindhoven Cancer Registry were included (N=5671). By means of active follow-up by the Cancer Registry staff within ten hospitals, data on development of metastatic disease were collected. Median follow-up was 5.0 years.RESULTS: Of the 5671 colorectal cancer patients, 1042 (18%) were diagnosed with metachronous metastases. Most common affected sites were the liver (60%), lungs (39%), extra-regional lymph nodes (22%), and peritoneum (19%). 86% of all metastases was diagnosed within three years and the median time to diagnosis was 17 months (interquartile range 10-29 months). Male gender (HR=1.2, 95%CI 1.03-1.32), an advanced primary T-stage (T4 vs. T3 HR=1.6, 95%CI 1.32-1.90) and N-stage (N1 vs. N0 HR=2.8, 95%CI 2.42-3.30 and N2 vs. N0 HR=4.5, 95%CI 3.72-5.42), high-grade tumour differentiation (HR=1.4, 95%CI 1.17-1.62), and a positive (HR=2.1, 95%CI 1.68-2.71) and unknown (HR=1.7, 95%CI 1.34-2.22) resection margin were predictors for metachronous metastases.CONCLUSIONS: Different patterns of metastatic spread were observed for colon and rectal cancer patients and differences in time to diagnosis were found. Knowledge on these patterns and predictors for metachronous metastases may enhance tailor-made follow-up schemes leading to earlier detection of metastasized disease and increased curative treatment options.",

keywords = "Adenocarcinoma, Adult, Aged, Aged, 80 and over, Colorectal Neoplasms, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Proportional Hazards Models, Registries, Journal Article, Research Support, Non-U.S. Gov't",

author = "{van Gestel}, {Yvette R B M} and {de Hingh}, {Ignace H J T} and {van Herk-Sukel}, {Myrthe P P} and {van Erning}, {Felice N} and Beerepoot, {Laurens V} and Wijsman, {Jan H} and Slooter, {Gerrit D} and Rutten, {Harm J T} and Creemers, {Geert-Jan M} and Lemmens, {Valery E P P}",

year = "2014",

month = aug,

doi = "10.1016/j.canep.2014.04.004",

language = "English",

volume = "38",

pages = "448--54",

journal = "Cancer Epidemiology",

issn = "1877-7821",

publisher = "Elsevier",

number = "4",

}

TY - JOUR

T1 - Patterns of metachronous metastases after curative treatment of colorectal cancer

AU - van Gestel, Yvette R B M

AU - de Hingh, Ignace H J T

AU - van Herk-Sukel, Myrthe P P

AU - van Erning, Felice N

AU - Beerepoot, Laurens V

AU - Wijsman, Jan H

AU - Slooter, Gerrit D

AU - Rutten, Harm J T

AU - Creemers, Geert-Jan M

AU - Lemmens, Valery E P P

PY - 2014/8

Y1 - 2014/8

N2 - BACKGROUND: This study aimed to provide information on timing, anatomical location, and predictors for metachronous metastases of colorectal cancer based on a large consecutive series of non-selected patients.METHODS: All patients operated on with curative intent for colorectal cancer (TanyNanyM0) between 2003 and 2008 in the Dutch Eindhoven Cancer Registry were included (N=5671). By means of active follow-up by the Cancer Registry staff within ten hospitals, data on development of metastatic disease were collected. Median follow-up was 5.0 years.RESULTS: Of the 5671 colorectal cancer patients, 1042 (18%) were diagnosed with metachronous metastases. Most common affected sites were the liver (60%), lungs (39%), extra-regional lymph nodes (22%), and peritoneum (19%). 86% of all metastases was diagnosed within three years and the median time to diagnosis was 17 months (interquartile range 10-29 months). Male gender (HR=1.2, 95%CI 1.03-1.32), an advanced primary T-stage (T4 vs. T3 HR=1.6, 95%CI 1.32-1.90) and N-stage (N1 vs. N0 HR=2.8, 95%CI 2.42-3.30 and N2 vs. N0 HR=4.5, 95%CI 3.72-5.42), high-grade tumour differentiation (HR=1.4, 95%CI 1.17-1.62), and a positive (HR=2.1, 95%CI 1.68-2.71) and unknown (HR=1.7, 95%CI 1.34-2.22) resection margin were predictors for metachronous metastases.CONCLUSIONS: Different patterns of metastatic spread were observed for colon and rectal cancer patients and differences in time to diagnosis were found. Knowledge on these patterns and predictors for metachronous metastases may enhance tailor-made follow-up schemes leading to earlier detection of metastasized disease and increased curative treatment options.

AB - BACKGROUND: This study aimed to provide information on timing, anatomical location, and predictors for metachronous metastases of colorectal cancer based on a large consecutive series of non-selected patients.METHODS: All patients operated on with curative intent for colorectal cancer (TanyNanyM0) between 2003 and 2008 in the Dutch Eindhoven Cancer Registry were included (N=5671). By means of active follow-up by the Cancer Registry staff within ten hospitals, data on development of metastatic disease were collected. Median follow-up was 5.0 years.RESULTS: Of the 5671 colorectal cancer patients, 1042 (18%) were diagnosed with metachronous metastases. Most common affected sites were the liver (60%), lungs (39%), extra-regional lymph nodes (22%), and peritoneum (19%). 86% of all metastases was diagnosed within three years and the median time to diagnosis was 17 months (interquartile range 10-29 months). Male gender (HR=1.2, 95%CI 1.03-1.32), an advanced primary T-stage (T4 vs. T3 HR=1.6, 95%CI 1.32-1.90) and N-stage (N1 vs. N0 HR=2.8, 95%CI 2.42-3.30 and N2 vs. N0 HR=4.5, 95%CI 3.72-5.42), high-grade tumour differentiation (HR=1.4, 95%CI 1.17-1.62), and a positive (HR=2.1, 95%CI 1.68-2.71) and unknown (HR=1.7, 95%CI 1.34-2.22) resection margin were predictors for metachronous metastases.CONCLUSIONS: Different patterns of metastatic spread were observed for colon and rectal cancer patients and differences in time to diagnosis were found. Knowledge on these patterns and predictors for metachronous metastases may enhance tailor-made follow-up schemes leading to earlier detection of metastasized disease and increased curative treatment options.

KW - Adenocarcinoma

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Colorectal Neoplasms

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasm Metastasis

KW - Proportional Hazards Models

KW - Registries

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.canep.2014.04.004

DO - 10.1016/j.canep.2014.04.004

M3 - Article

C2 - 24841870

SN - 1877-7821

VL - 38

SP - 448

EP - 454

JO - Cancer Epidemiology

JF - Cancer Epidemiology

IS - 4

ER -

Patterns of metachronous metastases after curative treatment of colorectal cancer

Abstract

Keywords

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