Evaluation of Recurrence Risk After Curative Resection for Patients With Stage I to III Colorectal Cancer Using the Hazard Function

Abstract

Objective:This study aimed to investigate transitions of recurrence hazard and peak recurrence time in patients with nonmetastatic CRC using the hazard function.Summary of Background Data:A postoperative surveillance period of 5 years is consistent across major guidelines for patients with nonmetastatic CRC, but surveillance intervals differ. Estimates of instantaneous conditional recurrence rate can help set appropriate intervals.Methods:The study population consisted of 4330 patients with stage I to III CRC who underwent curative resection at the National Cancer Center Hospital between January 2000 and December 2013. Hazard rates of recurrence were calculated using the hazard function.Results:Recurrence rates in patients with stage I, II, and III CRC were 4% (50/1432), 11% (136/1231), and 25% (424/1667), respectively. The hazard curve for stage I was relatively flat and hazard rates were consistently low (<0.0015) for 5 years after surgery. The hazard curve for stage II had a peak hazard rate of 0.0046 at 13.7 months, after which the curve had a long hem to the right. The hazard curve for stage III had an earlier and higher peak than that of stage II (0.0105 at 11.6 months), with a long hem to the right.Conclusions:Changes in recurrence hazard for CRC patients varied considerably by stage. Our findings suggest that short-interval surveillance might be unnecessary for stage I patients for the first 3 years after surgery, whereas short-interval surveillance for the first 3 years should be considered for stage III patients.

Impact of malnutrition on cancer recurrence, colorectal cancer‐specific death, and non‐colorectal cancer‐related death in patients with colorectal cancer who underwent curative surgery

“…The Kaplan-Meier method is used to estimate the survival function, which conveys information about cumulative probabilities of events at time t for the entire cohort. In contrast, the hazard function conveys information about the risk of events at time t for only those patients remaining at time t. [21][22][23][24][25] The recurrence hazard and peak recurrence time for each group were calculated using the RFS hazard function, with recurrence or death from any cause defined as an event. In addition, hazard function curves were created with recurrence only or each cause of death (all-cause, CRC-specific, or non-CRC related) as the endpoint.…”

Risk of non‐colorectal cancer‐related death in elderly patients with the disease: A comparison of five preoperative risk assessment indices

“…Patients were assessed by computed tomography every 6 months for 5 years and by colonoscopy 1 and 3 years after surgery as described previoussly. 28 , 29 Data on follow‐up were documented prospectively until an event occurred or until the study cut‐off date.…”

Hazard rate for postoperative recurrence in patients with hepatocellular carcinoma at Barcelona Clinic Liver Cancer stage 0 or A1: A multicenter observational study

“…To develop an appropriate follow-up strategy, it is essential to understand the transition trend of recurrence hazard, which is well studied in colorectal cancer and breast cancer [6][7][8] but not in the context of HCC. We hypothesize that the hazard rate of very early HCC is low; therefore, excessive close follow-up is not necessary.…”