# Analysis of risk factors for postoperative recurrence of stage I colorectal cancer: a retrospective analysis of a large population

## TL;DR

This study identifies risk factors for recurrence in stage I colorectal cancer patients, highlighting the importance of race, age, tumor stage, and CEA levels in predicting outcomes.

## Contribution

The study identifies independent risk factors for tumor recurrence in stage I CRC patients using a large population-based dataset.

## Key findings

- The recurrence rate in stage I CRC was 15.04%.
- Race, age, T stage, and CEA levels are independent risk factors for tumor recurrence.
- Radiotherapy is associated with survival benefits in stage I CRC patients.

## Abstract

Colorectal cancer (CRC) is the third most common cancer worldwide. Patients diagnosed with stage I CRC typically do not require postoperative adjuvant treatment. However, postoperative recurrence is present in at least 40% of patients with CRC and often occurs in those with stage I disease. This study aimed to elucidate the current status of recurrence and clinicopathological characteristics in patients with stage I CRC.

Data of indicated patients were obtained from 18 registries in Surveillance, Epidemiology, and End Results (SEER). The multivariable Fine–Gray regression model was used to identify the mortality risk of patients. Disparities in survival were analyzed using Kaplan–Meier curves. Logistic regression was employed to identify factors associated with recurrent risk overestimation.

Our study indicated a recurrence rate of 15.04% (1,874/12,452) in stage I CRC cases. Notably, we identified race, age, T stage, and carcinoembryonic antigen (CEA) levels as independent risk factors for tumor recurrence, substantially impacting prognosis. Furthermore, gender, race (Black), age (>65 years), elevated CEA levels, and refusal or unknown status regarding radiotherapy significantly correlated with an adverse prognosis in patients with stage I CRC.

We identified certain key clinicopathological features of patients with stage I CRC and demonstrated the survival benefits of radiotherapy, offering a new perspective on stage I CRC follow-up and treatment recommendations.