2nd February 2018, Volume 131 Number 1469

Ashok Gunawardene, Brendan Desmond, Ali Shekouh, Peter Larsen, Elizabeth Dennett

The New Zealand Ministry of Health has reported colorectal cancer (CRC) as the third most common cancer after prostate and breast, comprising almost 14% of all those registered in 2012,…

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Summary

In this article, the authors describe the patterns of disease recurrence in patients having curative surgery for colorectal cancer at a hospital in New Zealand over a three-year period. With five years of follow-up data, one in four patients experienced the cancer returning and this is in keeping with data reported in the worldwide literature. Recurrence most commonly occurred within the first two years, and the liver and lungs were the most common sites of recurrence.

Abstract

Aim

To describe the patterns of recurrence in a contemporaneous cohort of patients undergoing surgery with curative intent for colorectal adenocarcinoma at a New Zealand hospital with five-year follow-up.

Method

Patients with colorectal cancer undergoing potentially curative surgery between January 2010 and December 2012 were followed up for a median of 61 months with three-monthly CEA (carcinoembryonic antigen), a colonoscopy after one year and yearly computed tomography scans of the chest, abdomen and pelvis for the first three years.

Results

Overall, 59/237 (24.9%) of patients experienced disease recurrence, the most common sites being the liver, followed by the lung and local recurrence. Recurrence rates did not differ significantly between colon and rectal cancer and ranged from 5.1% in stage I to 60% in stage IV. Seventy-three percent of all recurrences were observed within the first 24 months post-operatively.

Conclusion

While New Zealand outcomes in colorectal cancer have historically compared unfavourably against international standards, the outcomes observed in this cohort are encouraging and may reflect advances in care, including multidisciplinary team discussion, increased use of adjuvant therapy, surgical subspecialisation and protocolled surveillance and follow-up.

Author Information

Ashok Gunawardene, Department of Surgery & Anaesthesia, University of Otago, Wellington;
Brendan Desmond, Department of General Surgery, Capital & Coast DHB, Wellington;
Ali Shekouh, Department of General Surgery, Capital & Coast DHB, Wellington;
Peter Larsen, Surgery & Anaesthesia, University of Otago, Wellington;
Elizabeth Dennett, Department of Surgery & Anaesthesia, University of Otago; Capital & Coast DHB, Wellington.

Correspondence

Dr Ashok Gunawardene, Department of Surgery & Anaesthesia, University of Otago, 23A Mein Street, Wellington 6242.

Correspondence Email

ashok.gunawardene@otago.ac.nz

Competing Interests

Dr Gunawardene reports grants from Wellington Surgical Research Trust, Phil & Teds, outside the submitted work. Dr Larsen reports grants from Wellington Medical Research Foundation, Lotteries Health Research, University of Otago Research Grant, outside the submitted work.

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