Establishing high risk factors for recurrence in stage I/II colorectal cancer: a metropolitan perspective

PMCID: PMC12175440

PMID: 40533762

DOI: 10.1186/s12957-025-03823-0

Journal: World journal of surgical oncology

Publication Date: 2025-6-18

Authors: Wood PC, Zammit AP, Ferris B, Simpson FH, Burge M, et al.

Key Points

• Overall recurrence rate of 13.3% in early-stage CRC, with stage II patients at higher risk
• Venous invasion, synchronous cancers, microsatellite status, and perioperative transfusion are significant recurrence predictors
• Current risk stratification models may be insufficient, necessitating more sophisticated approaches to guide adjuvant therapy

Summary

This retrospective cohort study investigated recurrence patterns and risk factors in early-stage colorectal cancer (CRC), analyzing 195 patients with stage I and II disease. The research aimed to improve risk stratification and treatment strategies for patients with early-stage CRC, revealing a notable recurrence rate of 13.3% overall, with stage II patients experiencing a higher recurrence risk of 17% compared to stage I patients at 8.4%.

Multivariate analysis identified four critical independent risk factors for disease recurrence: venous invasion (p=0.02), synchronous cancers (p=0.017), microsatellite stability (p=0.018), and perioperative blood transfusion (p=0.01). Notably, 19.2% of patients who experienced recurrence did not possess any of the six traditionally recognized risk factors, highlighting the complexity of predicting CRC progression and the need for more nuanced prognostic models.