Likelihood of Colon Cancer Recurrence

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testing765
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Joined: Tue Aug 19, 2014 9:41 am

Likelihood of Colon Cancer Recurrence

Postby testing765 » Sun Apr 03, 2016 5:17 pm

Hi. I have an appointment with my oncologist tomorrow. I wanted to get some clarification from him about the likelihood of colon cancer recurrence. I thought I had read on this forum that approximately 80 percent of recurrences happen within the first two years after resection surgery. There was some debate, however, as to whether the two year clock started to tick at the time of resection or if it started at the time of completing chemotherapy.

I did some research and I came across the following journal article and I have included the relevant section below. If I am reading this correctly, and if I am not please tell me, we were being overly optimistic by thinking that if we made it to two years without recurrence, our chances of not having a recurrence improved significantly. It looks like this journal article is saying that approximately 80 percent of recurrences happen within the first three years after resection surgery. Has anyone come across research literature supporting the position that approximately 80 percent of recurrences happen within the first two years after resection surgery. If so, please let me know.

A recently reported analysis of individual patient data from large adjuvant colon cancer randomised trials including >20 000 patients indicated that 82% of stage III and 74% of stage II colon cancer recurrences are diagnosed within the first 3 years after primary cancer resection [See footnote 49]. R. Labianca, Early colon cancer: ESMO Clinical Practice Guidelines
for diagnosis, treatment and follow-up, Annals of Oncology 24 (Supplement 6): vi64–vi72 at vi70, 2013.

Footnote 49. Sargent DJ, Patiyil S, Yothers G et al. Endpoints for colon cancer adjuvant trials: observations and recommendations based on individual patient data from 20,898 patients enrolled onto 18 randomized trials from the ACCENT group. J Clin Oncol 2007; 29: 4569–4574.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

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GreenLakeGirl
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Re: Likelihood of Colon Cancer Recurrence

Postby GreenLakeGirl » Sun Apr 03, 2016 6:12 pm

My surgeon and oncologist were both in agreement on observing the three-year mark. I never really figured out if it was three years after surgery or after the end of treatment (chemo), but I hadn't heard two years before. Most of my cc friends diagnosed before 50 report surveillance is more aggressive during first three years, and then it lessens.
2009, age 37 with a 2yo: CC, IIIB (T4N1M0). IBD history
2010-11: FOLFOX, 12 rounds. 5 surgeries (3-step Ileal j-pouch, infection, VATS)
Currently NED.
Mom, you can go the hard way if you want, but the easy way is much easier. ~my 3yo

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chrissyrice
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Re: Likelihood of Colon Cancer Recurrence

Postby chrissyrice » Sun Apr 03, 2016 9:07 pm

Hi,
I see that you had testing done and that you are MSI

This is a good ... lower recurrence than if you were MSS

Also good that there is more hope for good response to chemo and other immunotherapies for MSI as well as trials.

Make sure you read some of the posts here about the science and trial data threads.

Chrissy
Dx 10-31-09 Surgery 12-1-09 Sigmoid Colon Stage IIIb; Chemo Feb 2010-Aug 2010; 4 rounds Folfox; 8 rounds 5FU & Leucovorin;12-16-2010 PET/CT Scan Cancer Free;7-05-2012 CT Scan NED 2 years;10-13-2013 NED 3 yrs; 08-01-2014 NED 4 yrs; 06-30-2015 Stage 4 iliac lymph node(s) 08-11-2015 Surgery 3 cm tumor and iliac artery graft done. Positive margins in the abdominal aorta, No chemo. 03-16-2016 CT Scan Stable,06-16-2016 CT Scan Stable,09-21-2016 CT Scan Stable,12-2016 Stable,03-31-17 Stable,
Recurrence 6-30-17

Jacques
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Re: Likelihood of Colon Cancer Recurrence

Postby Jacques » Mon Apr 04, 2016 8:44 am

testing765 wrote:... Has anyone come across research literature supporting the position that approximately 80 percent of recurrences happen within the first two years after resection surgery. If so, please let me know...

I don't know the statistics for colon cancer, but for rectal cancer the local recurrence statistics look like this:
“...In 70% of cases, recurrence of rectal cancer occurs within two years of primary surgery, while 85% occurs within 3 years ... "

G. Palmer, A. Martling, B. Cedermark, and T. Holm, “A population-based study on the management and outcome in patients with locally recurrent rectal cancer,” Annals of Surgical Oncology, vol. 14, no. 2, pp. 447–454, 2007.
A. G. Heriot, C. M. Byrne, P. Lee et al., “Extended radical resection: the choice for locally recurrent rectal cancer,” Diseases of the Colon and Rectum, vol. 51, no. 3, pp. 284–291, 2008.

What I would do If I were you is to ask your oncologist to predict when a Stage III patient like you might experience a first recurrence, and if this were to happen then where would that recurrence most likely be located, and what would be the plan from that point onward. He might remember some past cases that are quite similar to yours.
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0,
5 years NED,
End of 6-month follow-ups: 7/2017
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testing765
Posts: 309
Joined: Tue Aug 19, 2014 9:41 am

Re: Likelihood of Colon Cancer Recurrence

Postby testing765 » Mon Apr 04, 2016 8:54 am

That is a good idea Jacques.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- clnscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/17- clnscopy- 4 polyps removed, CT scan NED, CEA 1.8
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

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NZJay
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Re: Likelihood of Colon Cancer Recurrence

Postby NZJay » Mon Apr 04, 2016 1:45 pm

My oncs quoted the 2-3 year mark for 80% of recurrences at stage 3. Which makes sense, because we scan at 2 and 3 years post-surgery.
11-13 Dx CC
SPS T4b(touched stomach organ),N1(3/23),M0(Stage 3B)
11-13: resect + partial gastrect
2-14: 1 Tx Cape + Oxy; renal failure, colitis
4-14: 7 Tx Capecitabine
1-15: clear CT
7-15: clear scope
1-16: clear CT
3-17: clear CT
10-17: clear scope (5 year gap now!)
CEA@dx: 8.4 / 6-15: 4.0 / 10-15: 4.2 / 2-16: 4.9 / 7-16: 4.9 / 11-16: 5.0 / 6-17: 4.5
NED since resection

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exaussie
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Re: Likelihood of Colon Cancer Recurrence

Postby exaussie » Wed Apr 06, 2016 9:45 am

I know that most of the time with cancer you are waiting for the other shoe to drop but please remember to LIVE LIFE! Keep a watchful eye but don't be overly concerned with statistics. My 2 cents.
DS 26 yrs old diagnosed 6/13 T3N2aM1b
Resection 6/13
6 rounds chemo folfax
12/13 Fissure
hernia surgery 12/13
5 months break
Maintenance chemo 3/14
Crazy growth. Liver failing. Folfox and vectibex 7-29-14
Chemo failure Hospice 8/26
Left us 8/28

Thetoad
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Re: Likelihood of Colon Cancer Recurrence

Postby Thetoad » Thu Apr 07, 2016 6:47 pm

I typed in 'recurrence statistics for colon cancer after two years' and found a few articles. Some do mention two years and 'the chances reduce dramatically after two years' etc. But I'm trying to avoid looking things up as I've found it a bit unsettling at times! I will be at two years and five months this coming Wednesday. All good so far.
Emergency extended rt hemi November 2013.
Complete blockage, small perforation.
Stage 2a.
T3N0M0
22 Lymph nodes clear.
No bag.

Now on yearly appts and 6 monthly CEA tests.
Incisional hernia repair with mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open surgery.
Pleasing consultation Feb. 2017
CEA 1.7 on 16/11/17
Clear colonoscopy Jan. 2018 :)
Colorectal nurse pleased, March 2018. Latest CEA 1.8. One more CEA test and hopefully last appt in November, 2018.

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Nik Colon
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Re: Likelihood of Colon Cancer Recurrence

Postby Nik Colon » Thu Apr 07, 2016 10:59 pm

Tbh, every time I go in its unnerving, but I would say the farther out the better. I'm not far out so can't say, but I'm sure no matter how far out its gonna cause anxiety to some degree.
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

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dianetavegia
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Re: Likelihood of Colon Cancer Recurrence

Postby dianetavegia » Fri Apr 08, 2016 8:38 am

Three years is what I was told, tho it does start to drop off at 2 years. My recurrence was found at my 3 year check up.

50% are cured by surgery alone and approximately 50% have recurrence at some point. I'm 4 years cancer free after my liver resection and the cure ratio shows a steep drop by year 4, which gives me great hope. At 6 years the hazard ratio is the same as the general public (liver resection).
Stage IIIB cc surgery 1/7/09. 5/17 nodes. 12 tx FOLFOX
Stage IVa 2/15/12. CEA 6.4 PET = 1.5cm liver met. HR 4/11/12 No chemo

Nine years 3 months since my original dx and Six years post liver resection.
NED April 2018!
“O Lord my God, I cried out to You, And You healed me.”
Psalms 30:2

Thetoad
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Re: Likelihood of Colon Cancer Recurrence

Postby Thetoad » Sat Apr 29, 2017 3:31 am

Thetoad wrote:I typed in 'recurrence statistics for colon cancer after two years' and found a few articles. Some do mention two years and 'the chances reduce dramatically after two years' etc. But I'm trying to avoid looking things up as I've found it a bit unsettling at times! I will be at two years and five months this coming Wednesday. All good so far.

Came across this post while looking for reassurance, (still worrying.) Coming up to 3 1/2 years soon and still no problems. CEA now 6 monthly and nurse yearly. (Hopeful sign?)
Emergency extended rt hemi November 2013.
Complete blockage, small perforation.
Stage 2a.
T3N0M0
22 Lymph nodes clear.
No bag.

Now on yearly appts and 6 monthly CEA tests.
Incisional hernia repair with mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open surgery.
Pleasing consultation Feb. 2017
CEA 1.7 on 16/11/17
Clear colonoscopy Jan. 2018 :)
Colorectal nurse pleased, March 2018. Latest CEA 1.8. One more CEA test and hopefully last appt in November, 2018.

cmrl
Posts: 172
Joined: Mon Apr 21, 2014 8:39 pm

Re: Likelihood of Colon Cancer Recurrence

Postby cmrl » Sat Apr 29, 2017 6:43 am

I asked my Oncologist yesterday at my checkup about the possibility of recurrence for Stage 3. He said that most recurrences occur within the first 3 years. He said there is a 30% chance of recurrence for 10 years.
Resection of splenic flexure 7/24/13
T3N2BM0, Stage 3c,12/29 nodes
Folfox x12 9/13-3/14
CT scan 4/14, enlarged spleen, otherwise clear
CT 4/15, spleen WNL.
6/17 3 cm benign polyp at ileocecal valve, awaiting removal

Thetoad
Posts: 158
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Location: New Zealand

Re: Likelihood of Colon Cancer Recurrence

Postby Thetoad » Thu Nov 02, 2017 12:54 am

Thetoad wrote:
Thetoad wrote:I typed in 'recurrence statistics for colon cancer after two years' and found a few articles. Some do mention two years and 'the chances reduce dramatically after two years' etc. But I'm trying to avoid looking things up as I've found it a bit unsettling at times! I will be at two years and five months this coming Wednesday. All good so far.

Came across this post while looking for reassurance, (still worrying.) Coming up to 3 1/2 years soon and still no problems. CEA now 6 monthly and nurse yearly. (Hopeful sign?)

Now it's just on 4 years and still ok. Waiting for a surveillance Coolnoscopy. So what are the chances of getting to 5 years now?Nobody seems to have statistics like that. Must be positve, but I'm nervous ...
Emergency extended rt hemi November 2013.
Complete blockage, small perforation.
Stage 2a.
T3N0M0
22 Lymph nodes clear.
No bag.

Now on yearly appts and 6 monthly CEA tests.
Incisional hernia repair with mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open surgery.
Pleasing consultation Feb. 2017
CEA 1.7 on 16/11/17
Clear colonoscopy Jan. 2018 :)
Colorectal nurse pleased, March 2018. Latest CEA 1.8. One more CEA test and hopefully last appt in November, 2018.

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ocstacy
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Re: Likelihood of Colon Cancer Recurrence

Postby ocstacy » Thu Nov 02, 2017 1:41 am

I thought I had read on this forum that approximately 80 percent of recurrences happen within the first two years after resection surgery. There was some debate, however, as to whether the two year clock started to tick at the time of resection or if it started at the time of completing chemotherapy.


I did mention in this support group of what my mother's colorectal surgeon told us based on her stage. I even recorded her entire doctor's appointment (with D the Dr's permission of course) I even asked him two times. He mentioned that 80% there is a re-occurance of it coming back. He did not mention in how many years but just the STATS, which I didn't like hearing at all. :| Maybe it's based on his experience, but he is a chief surgeon and he has been doing it for over 15 years.. not sure what to think?

But there is always hope and stay super positive. There are NED's and CPR's!! I pray for all of you as I am a caregiver and nursing student. I also used to work in the cancer center at Radiation Oncology about 18 years ago and I have seen a big difference in chemo med's, etc. I believe in Turmeric!
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 back @ hospital due 2 abscess/hernia - back home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Reversal 07/2018?
Me: Colonoscopy age 38. 08/17 Benign polp. internal hemmy's post partum

Thetoad
Posts: 158
Joined: Mon Nov 23, 2015 2:46 am
Location: New Zealand

Re: Likelihood of Colon Cancer Recurrence

Postby Thetoad » Fri Mar 09, 2018 1:17 am

Thetoad wrote:
Thetoad wrote:
Thetoad wrote:I typed in 'recurrence statistics for colon cancer after two years' and found a few articles. Some do mention two years and 'the chances reduce dramatically after two years' etc. But I'm trying to avoid looking things up as I've found it a bit unsettling at times! I will be at two years and five months this coming Wednesday. All good so far.

Came across this post while looking for reassurance, (still worrying.) Coming up to 3 1/2 years soon and still no problems. CEA now 6 monthly and nurse yearly. (Hopeful sign?)

Now it's just on 4 years and still ok. Waiting for a surveillance Coolnoscopy. So what are the chances of getting to 5 years now?Nobody seems to have statistics like that. Must be positve, but I'm nervous ...


And the colonoscopy on 9 Jan 2018 showed no abnormalities. 52 months NED very soon.
Emergency extended rt hemi November 2013.
Complete blockage, small perforation.
Stage 2a.
T3N0M0
22 Lymph nodes clear.
No bag.

Now on yearly appts and 6 monthly CEA tests.
Incisional hernia repair with mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open surgery.
Pleasing consultation Feb. 2017
CEA 1.7 on 16/11/17
Clear colonoscopy Jan. 2018 :)
Colorectal nurse pleased, March 2018. Latest CEA 1.8. One more CEA test and hopefully last appt in November, 2018.


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