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
Posts: 777
Joined: Mon Jan 18, 2010 5:55 am
Location: Pacific NW

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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Joined: Thu Sep 23, 2010 8:44 am
Location: Atlanta, Georgia

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 T3,N2,MX; Chemo Feb 2010-Aug 2010; 4 rounds Folfox; 8 rounds 5FU +LV
12/2010 PET/CT Scan, Cancer Free
7/2012 CT Scan NED 2 years
10/2013 NED 3 years
8/2014 NED 4 years
Recurrence 6/2015: iliac lymph node(s)
8/2015 Surgery: 3 cm tumor removed+iliac artery graft
3/2016 CT Scan Stable
6/2016 Stable
9/2016 Stable
12/2016 Stable
3/2017 Stable
Recurrence 6/2017
12/2017 Surgery removed all cancer w/ clean margins
07-27-2018 Cancer-free for 7 months

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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.

testing765
Posts: 324
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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Location: NZ

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
Posts: 165
Joined: Mon Nov 23, 2015 2:46 am
Location: New Zealand

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.

Yearly appts appts and 6 monthly CEA tests.
Incisional hernia repair, mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open.
Good consultation Feb. 2017
CEA 1.7 on 16/11/17 colonoscopy ok Jan. 2018 :)
Nurse pleased, March 2018. CEA 1.8. One more CEA test and hopefully last appt in November, 2018.
Prostate cancer, Gleason 7 (3+4) Sept. '18.

Nik Colon

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.

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dianetavegia
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Location: Villa Rica, Georgia

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 III cc surgery 1/7/09. 12 tx FOLFOX
Stage IV PET = 1.5cm liver met. HR 4/11/12

14 years since dx and 11 years post liver resection.
Pronounced CURED and discharged by onc

“O Lord my God, I cried out to You, And You healed me.” Psalms 30:2

Thetoad
Posts: 165
Joined: Mon Nov 23, 2015 2:46 am
Location: New Zealand

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.

Yearly appts appts and 6 monthly CEA tests.
Incisional hernia repair, mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open.
Good consultation Feb. 2017
CEA 1.7 on 16/11/17 colonoscopy ok Jan. 2018 :)
Nurse pleased, March 2018. CEA 1.8. One more CEA test and hopefully last appt in November, 2018.
Prostate cancer, Gleason 7 (3+4) Sept. '18.

cmrl
Posts: 174
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: 165
Joined: Mon Nov 23, 2015 2:46 am
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.

Yearly appts appts and 6 monthly CEA tests.
Incisional hernia repair, mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open.
Good consultation Feb. 2017
CEA 1.7 on 16/11/17 colonoscopy ok Jan. 2018 :)
Nurse pleased, March 2018. CEA 1.8. One more CEA test and hopefully last appt in November, 2018.
Prostate cancer, Gleason 7 (3+4) Sept. '18.

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ocstacy
Posts: 264
Joined: Mon Jun 19, 2017 11:29 pm
Facebook Username: stacy

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 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

Thetoad
Posts: 165
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.

Yearly appts appts and 6 monthly CEA tests.
Incisional hernia repair, mesh Nov. 2014.
Cellulitus
CEA 1.4 on 28/7/17
27/5/17. Gallbladder removed, open.
Good consultation Feb. 2017
CEA 1.7 on 16/11/17 colonoscopy ok Jan. 2018 :)
Nurse pleased, March 2018. CEA 1.8. One more CEA test and hopefully last appt in November, 2018.
Prostate cancer, Gleason 7 (3+4) Sept. '18.


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