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Background <p>The evolving prognosis of colorectal cancer (CRC) over extended periods following surgery has not been comprehensively characterized. This study aimed to delineate long-term patterns in conditional survival (CS), evaluate the changing relevance of CRC recurrence surveillance versus management of fatal non-cancer conditions, and suggest follow-up indicators tailored to postoperative duration.</p> Methods <p>We examined trends in conditional overall survival (cOS), disease-specific survival (cDSS), and non-disease-specific survival (cNDSS) by tumor stage in 2,996 patients (stage 0–IV) who underwent surgical resection for CRC. Furthermore, we conducted a multivariate analysis in a cohort of 1,529 patients surviving more than 5&#xa0;years to identify predictors of long-term survival.</p> Results <p>Over a median observation period of 60.4&#xa0;months, 745 deaths were recorded (478 CRC-related, 243 unrelated to CRC, and 24 unknown). Stage-wise CS analyses revealed crossover points of cDSS and cNDSS at 3&#xa0;years post-surgery in stage II and at 6&#xa0;years in stages III/IV. Multivariate analysis identified age ≥ 80, CEA ≥ 5.0&#xa0;ng/mL, CA19-9 ≥ 37.0 U/mL, albumin ≤ 4.1&#xa0;g/dL, anemia, RDW ≥ 14.9%, and platelet count ≤ 150 × 10<sup>9</sup>/L as independent risk factors in 5-year survivors.</p> Conclusions <p>The importance of CRC recurrence surveillance was most prominent within the first 3&#xa0;years after surgery in stage II and within 6&#xa0;years in stages III/IV. Our findings underscore the need to customize surveillance strategies based on duration since surgery and indicate that the aforementioned clinical parameters may serve as useful markers in 5-year survivors.</p>

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Sequential changes in conditional survival of patients following surgical resection of colorectal cancer and indicators for follow-up beyond 5 years

  • 期刊论文

  • 发表日期：

    2026年1月5日

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  • Ryotaro Goto,
  • Hideo Miyake,
  • Hidemasa Nagai,
  • Yuichiro Yoshioka,
  • Junichi Takamizawa,
  • Norihiro Yuasa

摘要

Background

The evolving prognosis of colorectal cancer (CRC) over extended periods following surgery has not been comprehensively characterized. This study aimed to delineate long-term patterns in conditional survival (CS), evaluate the changing relevance of CRC recurrence surveillance versus management of fatal non-cancer conditions, and suggest follow-up indicators tailored to postoperative duration.

Methods

We examined trends in conditional overall survival (cOS), disease-specific survival (cDSS), and non-disease-specific survival (cNDSS) by tumor stage in 2,996 patients (stage 0–IV) who underwent surgical resection for CRC. Furthermore, we conducted a multivariate analysis in a cohort of 1,529 patients surviving more than 5 years to identify predictors of long-term survival.

Results

Over a median observation period of 60.4 months, 745 deaths were recorded (478 CRC-related, 243 unrelated to CRC, and 24 unknown). Stage-wise CS analyses revealed crossover points of cDSS and cNDSS at 3 years post-surgery in stage II and at 6 years in stages III/IV. Multivariate analysis identified age ≥ 80, CEA ≥ 5.0 ng/mL, CA19-9 ≥ 37.0 U/mL, albumin ≤ 4.1 g/dL, anemia, RDW ≥ 14.9%, and platelet count ≤ 150 × 109/L as independent risk factors in 5-year survivors.

Conclusions

The importance of CRC recurrence surveillance was most prominent within the first 3 years after surgery in stage II and within 6 years in stages III/IV. Our findings underscore the need to customize surveillance strategies based on duration since surgery and indicate that the aforementioned clinical parameters may serve as useful markers in 5-year survivors.