Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.6964
Peer-review started: February 10, 2021
First decision: March 15, 2021
Revised: March 31, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: August 26, 2021
Processing time: 194 Days and 10.3 Hours
To discuss recurrence patterns and their significance in colorectal cancer. Preexisting medical hypotheses and the clinical phenomena of recurrence in colorectal cancer were evaluated and integrated. Colorectal cancer recurrence/ metastasis consists of two types: recurrence from the activation of dormant cancer cells and recurrence from postoperative residual cancer cells. These two recurrences have their own unique mechanisms, biological behaviors, responses to therapy, and prognoses. For type 1 recurrences, surgical resection should be considered. Type 2 recurrences should be managed systematically in addition to surgical resection. The two types of colorectal cancer recurrence should be evaluated and managed separately.
Core Tip: In this work, we proposed the recurrence/metastasis of colorectal cancer consists of two types: recurrence from activation of dormant cancer cells and recurrence from proliferation of post-operative residual cancer cells. These two recurrences have their own unique mechanisms, biological behaviors, response to therapy, and prognosis. For type 1 recurrences, surgical resection should be considered. Type 2 recurrences should be managed systematically, in addition to surgical resection. Our theory also suggests that the tumor-node-metastasis staging system should be re-evaluated.