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The other shoe

SandiaBuddy's picture
SandiaBuddy
Posts: 558
Joined: Apr 2017

I have been unable to get the full text of this article, but the information in it still interests me.  This is a single center recurrence rate after "curative" surgery.  I assume it is for stages I - III of colorectal cancer, so it is a crude tool, but yet, this is the only place I have seen the information in this format.  So, for me, a stage 3, it gives me some sense of statistically (and none of us are statistics) when the other shoe might drop:

Year     Cumulative recurrence     Single year recurrence

  1            27.50%                                   27.50%

  2            57.50%                                   30.00%

  3            74.60%                                   17.10%

  4            85.50%                                    10.90%

  5             89.60%                                    4.10%

 

https://onlinelibrary.wiley.com/doi/full/10.1111/ans.14870

Between 1995 and 2010, 2575 patients with CRC underwent surgery. After exclusions, 386 had recurrence following potentially curative resection, ranging from 1 to 172.5 months (median 20.3) after treatment. Within 1 year, 27.5% recurred, 57.5% by 2 years, 74.6% by 3 years, 85.5% by 4 years and 89.6% by 5 years. There was no difference in time to recurrence between colon and rectal cancers (P = 0.674). Among patients having a potentially curative resection for rectal cancer between 1971 and 2010, 386 recurred. There was no difference in time to recurrence by decade (P = 0.863). . . The majority of recurrences occurred within 3 years of curative treatment. Had surveillance been limited to 5 years, detection of more than 10% of recurrences would have been delayed. Time to recurrence for rectal cancer has not changed in over 40 years, despite treatment advances.

myAZmountain
Posts: 113
Joined: Apr 2018

Reading about this study I couldn't figure out if the total number of patients for both studies was 2575 or was that the total  number for just the 1995-2010 group?  

SandiaBuddy's picture
SandiaBuddy
Posts: 558
Joined: Apr 2017

Yeah, that is ambiguos and why I like to read the whole thing--but not at the cost of $40.  My guess is that is the total number.

SandiaBuddy's picture
SandiaBuddy
Posts: 558
Joined: Apr 2017

Tanstaafl was kind enough to provide me with a copy of the full study.  It says, "Recurrence of rectal cancers had been recorded since 1971 whereas colon cancer recurrence was recorded only from 1995 onward. Therefore, two patient cohorts were selected for analysis: (i) colonic and rectal cancer patients from 1995 to 2010 inclusive in order to examine the distribution of time to recurrence; and (ii) rectal cancer patients from 1971 to 2010 in order to evaluate time to recurrence over a prolonged time period."

beaumontdave's picture
beaumontdave
Posts: 830
Joined: Aug 2013

Interesting, so if you make it to the 6 year marker, the odds are still better than 1in10 of a recurrence. Made it to about 3 years twice, 4+ years currently, maybe the d*mn stuff will get bored with me, lol.........................................................................Dave

abita's picture
abita
Posts: 447
Joined: Dec 2017

Did you have surgery with each recurrence? Someone asked me yesterday what step is to follow my last treatment in a month for my recurrence, and I had to say, I have no idea. I know surgery isn't eligible for me, but my oncologist hasn't said what next. I am wondering if it is just the waiting game, scans until it comes back then chemo again.

beaumontdave's picture
beaumontdave
Posts: 830
Joined: Aug 2013

Yes, both times a liver resection, first three mets, then one...................................Dave

Mikenh's picture
Mikenh
Posts: 797
Joined: Oct 2017

I only looked at what was available for free. I do not think that I could get access to this article without a trip to a university research library and that would mean a lot of driving.

It is not clear to me if the recurrence is a true recurrence where some cancerous cells were missed and they came back or if it's a new cancer. I would guess that it would be difficult to tell as there would have to be pathology and even genomic analysis of the two tumors for comparison and that such stuff was rare or maybe not even possible when the study started. So it could be that the conditions which spawned the first cancer were present at some time so that a similar or the same cancer recurred.

The lifetime risk of CRC is 4.5%. If you get CRC, and are cured, then you still have a risk of getting it again - unrelated to the first time. Hopefully most of us have made lifestyle changes to reduce those odds though.

Annabelle41415's picture
Annabelle41415
Posts: 5810
Joined: Feb 2009

With my cancer they suggested my treatment based on previous patients but my oncologist never took into consideration the harm she was doing to my body with continuing treatment now giving me permanent neuropathy.  Sometimes treatment needs to be adjusted and for them not to go just by statistics.  Interesting post though.  Just guess that wouldn't ever be the article that I'd want to look up.  Thanks for posting.

Kim

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