Zhou XM, Zeng ZY, Liu BG, Yin NN, Qu HB. Relationship between postoperative tumor recurrence time and long-term survival in colorectal cancer patients. World J Gastrointest Surg 2026; 18(7): 119305 [DOI: 10.4240/wjgs.119305]
Corresponding Author of This Article
Hai-Bo Qu, Department of Gastrointestinal Surgery, The Central Hospital of Yongzhou, No. 396 Yiyun Road, Lengshuitan District, Yongzhou 425000, Hunan Province, China. quhaibo576@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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research-article
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Zhou XM, Zeng ZY, Liu BG, Yin NN, Qu HB. Relationship between postoperative tumor recurrence time and long-term survival in colorectal cancer patients. World J Gastrointest Surg 2026; 18(7): 119305 [DOI: 10.4240/wjgs.119305]
Xiang-Mao Zhou, Zhi-Yao Zeng, Bing-Gang Liu, Hai-Bo Qu, Department of Gastrointestinal Surgery, The Central Hospital of Yongzhou, Yongzhou 425000, Hunan Province, China
Na-Na Yin, Department of Gynecology, The Central Hospital of Yongzhou, Yongzhou 425000, Hunan Province, China
Author contributions: Zhou XM and Qu HB designed the study; Zeng ZY and Liu BG collected and analyzed the data; Yin NN assisted with data organization; Zhou XM drafted the manuscript. All authors approved the final version.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Central Hospital of Yongzhou (Approval No. 2025120501). All procedures were conducted in accordance with the Declaration of Helsinki and relevant institutional guidelines.
Informed consent statement: Given the retrospective design of this study, the requirement for written informed consent was waived by the Ethics Committee of The Central Hospital of Yongzhou. All patient data were anonymized prior to analysis, and no identifiable personal information was included.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this study.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
Corresponding author: Hai-Bo Qu, Department of Gastrointestinal Surgery, The Central Hospital of Yongzhou, No. 396 Yiyun Road, Lengshuitan District, Yongzhou 425000, Hunan Province, China. quhaibo576@163.com
Received: January 23, 2026 Revised: February 24, 2026 Accepted: April 7, 2026 Published online: July 27, 2026 Processing time: 185 Days and 1.1 Hours
Abstract
BACKGROUND
Colorectal cancer (CRC) remains a major global health challenge, with over 1.9 million new cases annually and ranking third in cancer-related mortality. Despite advances in surgical techniques and multimodal therapy, post-operative recurrence occurs in 30%-50% of patients, representing the primary cause of treatment failure. Recurrence timing shows distinct temporal patterns, with 70%-80% occurring within 2-3 years post-surgery, suggesting different biological behaviors and clinical significance. However, the relationship between recurrence timing and long-term survival outcomes remains inadequately characterized, particularly in Chinese populations, limiting risk stratification and individualized treatment strategies.
AIM
To investigate the relationship between post-operative tumor recurrence time and long-term survival rate in CRC patients, providing a basis for clinical prognosis assessment and follow-up strategy formulation.
METHODS
A retrospective analysis was conducted on clinical data from 120 CRC patients who underwent curative surgery at our hospital from January 2015 to December 2018 and subsequently experienced recurrence. Patients were divided into early recurrence group (recurrence ≤ 2 years post-surgery, n = 63) and late recurrence group (recurrence > 2 years post-surgery, n = 57) based on time to recurrence. Clinical pathological characteristics, recurrence sites, treatment methods and other data were collected. Kaplan-Meier method was used to plot survival curves, Log-rank test was used to compare overall survival (OS) and post-recurrence survival (PRS) between groups, and Cox proportional hazards regression model was used to analyze independent risk factors affecting prognosis.
RESULTS
The median OS for early and late recurrence groups were 36.8 months and 68.5 months respectively, and median PRS were 14.6 months and 33.2 months respectively, with statistically significant differences (P < 0.001). The 3-year and 5-year OS rates for the early recurrence group were 39.7% and 22.2% respectively, while for the late recurrence group they were 80.7% and 57.9% respectively (P < 0.001). Multivariate analysis showed that recurrence time [hazard ratio (HR) = 2.41, 95% confidence interval (CI): 1.56-3.72, P < 0.001], TNM staging (HR = 1.92, 95%CI: 1.26-2.94, P = 0.003), and post-recurrence treatment modality (HR = 1.71, 95%CI: 1.18-2.48, P = 0.005) were independent prognostic factors affecting OS.
CONCLUSION
Post-operative recurrence time in CRC is closely related to long-term patient survival, with early recurrence patients having significantly worse prognosis than late recurrence patients. The first 2 years post-surgery represent a high-risk period for recurrence, requiring enhanced follow-up monitoring. Early recurrence patients need active comprehensive treatment measures to improve prognosis.
Core Tip: This study demonstrates that postoperative recurrence time is a strong and independent predictor of long-term outcomes in colorectal cancer (CRC) patients. Early recurrence (≤ 2 years after surgery) is associated with more aggressive pathological features and significantly worse overall survival and post-recurrence survival compared with late recurrence. Recurrence time provides prognostic information beyond tumor-node-metastasis staging and helps refine follow-up strategies and guide individualized treatment. Incorporating recurrence time into clinical decision-making may improve risk stratification and management of CRC patients.
