Risk factors for recurrence in stage I colorectal cancer after curative resection: a systematic review and meta-analysis.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2025-01-01 Epub Date: 2025-01-07 DOI:10.4174/astr.2025.108.1.39

Sung Hwan Hwang, Seon-Hi Shin, Yun Jin Kim, Jun Ho Lee

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引用次数: 0

Abstract

Purpose: Patients with stage I colorectal cancer (CRC) rarely experience recurrence after curative resection. Therefore, the risk factors for stage I CRC recurrence are yet to be established. We aimed to identify risk factors for stage I CRC recurrence.

Methods: MEDLINE, Embase, and Cochrane Library were searched for articles published between 1990 and 2022. The pooled proportions and hazard ratios (HRs) were calculated. Fixed- or random-effect models were considered based on heterogeneity, using Cochran's Q-statistic and the I²-test.

Results: Nine studies involving 19,440 patients were included. Nine analyzed risk factors were identified. T2 stage (pooled HR, 2.070; 95% confidence interval [CI], 1.758-2.438; P < 0.001; I²=0.0%), lymphovascular invasion (HR, 1.685; 95% CI, 1.420-1.999; P < 0.001; I² = 0.0%), venous invasion (HR, 1.794; 95% CI, 1.515-2.125; P < 0.001; I² = 0.0%), CEA level (HR, 1.472; 95% CI, 1.093-1.983; P = 0.011; I² = 1.8%) and rectal cancer (HR, 2.981; 95% CI, 2.378-3.735; P < 0.001; I² = 0.0%) were risk factors for the recurrence. However, the risk of recurrence in right-sided colon cancer was lower than in left-sided colon cancer. (HR, 0.712; 95% CI, 0.537-0.944; P = 0.018; I² = 0.0%). No statistically significant differences were observed in the number of harvested lymph nodes, age, and sex.

Conclusion: T2 stage, lymphovascular invasion, venous invasion, CEA level, rectal cancer, and left-sided colon cancer were risk factors for recurrence in stage I CRC. Intensive monitoring and surveillance are warranted for patients with high-risk features of recurrence.

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一期结直肠癌根治性切除后复发的危险因素：一项系统回顾和荟萃分析。

目的：一期结直肠癌（CRC）在根治性切除后很少复发。因此，一期CRC复发的危险因素尚未确定。我们的目的是确定I期CRC复发的危险因素。方法：检索MEDLINE、Embase和Cochrane图书馆1990 - 2022年间发表的文章。计算合并比例和风险比（hr）。采用Cochran’s q统计量和i2检验，基于异质性考虑固定效应或随机效应模型。结果：纳入9项研究，共19440例患者。确定了9个分析的危险因素。T2期(合并HR， 2.070；95%置信区间[CI]， 1.758-2.438；P < 0.001；I2=0.0%)，淋巴血管侵袭(HR, 1.685；95% ci, 1.420-1.999；P < 0.001；I2 = 0.0%)，静脉侵入(HR, 1.794；95% ci, 1.515-2.125；P < 0.001；I2 = 0.0%)， CEA水平(HR, 1.472；95% ci, 1.093-1.983；P = 0.011；I2 = 1.8%)和直肠癌(HR, 2.981；95% ci, 2.378-3.735；P < 0.001；I2 = 0.0%)是复发的危险因素。然而，右侧结肠癌的复发风险低于左侧结肠癌。(HR 0.712;95% ci, 0.537-0.944；P = 0.018；I2 = 0.0%)。在淋巴结数量、年龄和性别方面没有统计学上的显著差异。结论：T2分期、淋巴血管浸润、静脉浸润、CEA水平、直肠癌、左侧结肠癌是I期结直肠癌复发的危险因素。有复发高危特征的患者应加强监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).