Background: Colorectal cancer (CRC) carries a significant disease burden worldwide. With the implementation of screening programs for colorectal cancer, the incidence of early-stage disease is increasing. As such, it is imperative to revise and optimise our risk stratification and treatment pathways for this patient cohort.
Methods: This retrospective cohort study analyses clinicopathological features of early colorectal cancer from our institutional database between 2010 and 2020. Univariate and multivariable analyses were used to identify clinical and disease factors that may be associated with disease recurrence.
Results: 195 patients with stage one and two colorectal cancers were identified. Twenty-six patients experienced recurrence overall (13.3%). Recurrence rates were 8.4% and 17% in stage I and II disease, respectively. 19.2% of patients with recurrence did not possess any of the six commonly recognised risk factors. 5-year mortality rate for those patients who experienced recurrence was 61.5%. Using a multivariable model, venous invasion (p = 0.02), synchronous cancers (p = 0.017), microsatellite stability (p = 0.018) and peri-operative blood transfusion (p = 0.01) were found to be risk factors for recurrence.
Conclusion: Early colorectal cancers carry a significant risk of recurrence and associated disease burden. Currently identified risk factors may not provide the full picture in terms of prognostic impact. Optimisation of risk stratification will assist to guide adjuvant therapy in this group of patients.
Keywords: Colorectal neoplasms; Recurrence.
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