J Cancer 2014; 5(4):272-280. doi:10.7150/jca.8871 This issue


Future Directions for the Early Detection of Colorectal Cancer Recurrence

Avery S. Walker1, Eric K. Johnson1, Justin A. Maykel2, Alex Stojadinovic3, Aviram Nissan4, Bjorn Brucher5, Bradley J. Champagne6, Scott R. Steele1✉

1. Department of Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Dr., Fort Lewis, WA, USA.
2. University of Massachusetts Memorial Medical Center, Worcester, MA, USA.
3. Department of Surgery, Division of Surgical Oncology, Walter Reed National Military Medical Center, Bethesda, MD, USA
4. Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
5. Bon Secours Cancer Institute, Richmond VA, USA
6. University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA.

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Walker AS, Johnson EK, Maykel JA, Stojadinovic A, Nissan A, Brucher B, Champagne BJ, Steele SR. Future Directions for the Early Detection of Colorectal Cancer Recurrence. J Cancer 2014; 5(4):272-280. doi:10.7150/jca.8871. Available from https://www.jcancer.org/v05p0272.htm

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Surgical resection remains a mainstay of treatment and is highly effective for localized colorectal cancer. However, ~30-40% of patients develop recurrence following surgery and 40-50% of recurrences are apparent within the first few years after initial surgical resection. Several variables factor into the ultimate outcome of these patients, including the extent of disease, tumor biology, and patient co-morbidities. Additionally, the time from initial treatment to the development of recurrence is strongly associated with overall survival, particularly in patients who recur within one year of their surgical resection. Current post-resection surveillance strategies involve physical examination, laboratory, endoscopic and imaging studies utilizing various high and low-intensity protocols. Ultimately, the goal is to detect recurrence as early as possible, and ideally in the asymptomatic localized phase, to allow initiation of treatment that may still result in cure. While current strategies have been effective, several efforts are evolving to improve our ability to identify recurrent disease at its earliest phase. Our aim with this article is to briefly review the options available and, more importantly, examine emerging and future options to assist in the early detection of colon and rectal cancer recurrence.

Keywords: Colorectal cancer, recurrence, biomarkers.