Clinicopathological and Molecular Features of Patients with Early and Late Recurrence after Curative Surgery for Colorectal Cancer

SIMPLE SUMMARY: Colorectal cancer patients with early recurrence had advanced pathological node categories, pathological tumor, node, metastasis stages, adjuvant chemotherapy treatment, a worse overall survival rate, more liver metastases and more APC mutations than those with late recurrence. Patients with right-sided colon cancer tended to have early recurrence than those with left-sided colon cancer or rectal cancer. The postrecurrence survival rates were not significantly different between patients with early and late recurrence, which was observed in right-sided colon, left-sided colon and rectum. Multivariate analysis showed that old age, early recurrence, multiple-site recurrence and BRAF and NRAS mutations were independent prognostic factors. ABSTRACT: Background: Few reports have investigated genetic alterations between patients with early and late recurrence following curative surgery for colorectal cancer (CRC). Methods: A total of 1227 stage I–III CRC patients who underwent curative resection were included retrospectively. Among them, 236 patients had tumor recurrence: 139 had early (<2 years after surgery) and 97 had late (≥2 years after surgery) recurrence. Clinicopathological features and genetic alterations were compared between the two groups. Results: Compared to those with late recurrence, patients with early recurrence were more likely to have advanced pathological node (N) categories; tumor, node, metastasis (TNM) stages; adjuvant chemotherapy treatment; liver metastases; APC mutations; and worse five-year overall survival rates. Patients with right-sided colon cancer were more likely to develop early recurrence than were those with left-sided colon cancer or rectal cancer. Regarding rectal cancer, patients with early recurrence were more likely to be at advanced pathological N categories and TNM stages than those with late recurrence. Multivariate analysis revealed old age, early recurrence, multiple-site recurrence, and BRAF and NRAS mutations to be independent prognostic factors. Conclusion: CRC patients with early recurrence have a worse OS rate and more APC mutations than those with late recurrence.