{ "abstract": "Introduction: After curative surgery for colorectal cancer (CRC), patients undergo surveillance because of the risk of recurrence; however, only a subset develops recurrence amenable to further curative-intent treatment. The primary aim of follow‑up is to identify patients with potentially curable recurrence. Materials and methods: A retrospective analysis was performed of stage I–IV CRC patients who underwent curative-intent treatment and entered postoperative surveillance at Isala between 2014 and 2018. Follow‑up was conducted according to Dutch guideline‑based protocols for 60 months. Patients were categorized as having no recurrence, a potentially curable recurrence, or a non-curable recurrence. Prognostic factors at start of follow-up for potentially curable recurrence were assessed using competing‑risk Cox regression, with non-curable recurrence and death as competing events. For patients with recurrence, mode and time of detection were evaluated. Results: During a median follow-up of 60 months, recurrence occurred in 22.4% of 1118 patients. The cumulative incidence function (CIF) of a potentially curable recurrence was 8.0%. Independent variables associated with a potentially curable recurrence were age HR 0.97 (95% CI 0.96–0.99), minor postoperative complications HR 1.78 (95% CI 1.16–2.72), stage III CRC HR2.76 (95% CI 1.19–6.38) and stage IV CRC HR 11.02 (95% CI 4.44–27.37). Among patients with a recurrence, CEA ≥ 5 ng/mL was present in 63% of all recurrences, but less often in the potentially curable group (57% vs. 69%, p = 0.057). Median time to detection of a potentially curable recurrence was 16 months (IQR 20). The overall number needed to follow-up (NNFU) to detect one potentially curable recurrence was 9.8, with the lowest NNFU observed in stage IV CRC (2.3) and in rectal cancer (6.9). Conclusion: Standard follow-up enabled the detection of potentially curable recurrence in 8% of CRC patients. The substantial variation in NNFU across subgroups and the limited sensitivity of CEA underscore the need for more personalized, risk‑adapted surveillance strategies.", "abstract_shown": true, "affiliations": [ "Oncology Center Isala, Isala, Zwolle, the Netherlands.", "Department of Health Science, Section of Nursing Research, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.", "Department of Epidemiology & Statistics, Isala, Zwolle, the Netherlands.", "Department of Gastroenterology and Hepatology, Isala, Zwolle, the Netherlands.", "Department of Surgery, Isala, Zwolle, the Netherlands." ], "article_type": "Research Article", "arxiv": null, "author_total": 7, "authors": [ { "affs": [ 0, 1 ], "name": "Ivonne J H Schoenaker", "orcid": "0000-0002-8628-8134" }, { "affs": [ 2 ], "name": "Richard M Brohet" }, { "affs": [ 1 ], "name": "Evelyn J Finnema" }, { "affs": [ 0 ], "name": "Dominique C Damminga" }, { "affs": [ 0 ], "name": "Helle-Brit Fiebrich" }, { "affs": [ 3 ], "name": "Wouter H de Vos Tot Nederveen Cappel", "orcid": "0000-0002-3956-1206" }, { "affs": [ 4 ], "name": "Henderik L van Westreenen" } ], "bibtex": "https://research.draconitic.com/paper/6yh813atnqa63.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0361933", "fulltext_url": "https://europepmc.org/articles/PMC13722166", "id": "6yh813atnqa63", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0361933", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Basic Cancer Research" ], [ "heading", "Cancer Risk Factors" ], [ "heading", "Cancer Treatment" ], [ "heading", "Cancers and Neoplasms" ], [ "heading", "Clinical Medicine" ], [ "heading", "Clinical Oncology" ], [ "heading", "Colorectal Cancer" ], [ "heading", "Disease Surveillance" ], [ "heading", "Epidemiology" ], [ "heading", "Gastrointestinal Tumors" ], [ "heading", "Medical Risk Factors" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Metastasis" ], [ "heading", "Oncology" ], [ "heading", "Rectal Cancer" ], [ "heading", "Research Article" ], [ "heading", "Surgical Oncology" ], [ "heading", "Surgical Resection" ], [ "heading", "Surgical and Invasive Medical Procedures" ], [ "heading", "Tumor Resection" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Clinical oncology/Surgical oncology" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Clinical oncology/Surgical oncology/Tumor resection" ], [ "plos", "/Medicine and health sciences/Epidemiology/Disease surveillance" ], [ "plos", "/Medicine and health sciences/Epidemiology/Medical risk factors/Cancer risk factors" ], [ "plos", "/Medicine and health sciences/Oncology/Basic cancer research/Metastasis" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer risk factors" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer treatment" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer treatment/Surgical oncology" ], [ "plos", "/Medicine and health sciences/Oncology/Cancer treatment/Surgical oncology/Tumor resection" ], [ "plos", "/Medicine and health sciences/Oncology/Cancers and neoplasms/Colorectal cancer" ], [ "plos", "/Medicine and health sciences/Oncology/Cancers and neoplasms/Gastrointestinal tumors/Rectal cancer" ], [ "plos", "/Medicine and health sciences/Oncology/Clinical oncology/Surgical oncology" ], [ "plos", "/Medicine and health sciences/Oncology/Clinical oncology/Surgical oncology/Tumor resection" ], [ "plos", "/Medicine and health sciences/Oncology/Metastasis" ], [ "plos", "/Medicine and health sciences/Surgical and invasive medical procedures/Surgical resection/Tumor resection" ] ], "openalex": null, "pdf_url": "https://europepmc.org/articles/PMC13722166?pdf=render", "pmcid": "PMC13722166", "pmid": "42961958", "published": "2026-10-30", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/6yh813atnqa63.ris", "sources": [ { "first_seen": "2026-10-31T12:20:55Z", "native_id": "10.1371/journal.pone.0361933", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0361933" }, { "first_seen": "2026-11-02T03:21:21Z", "native_id": "MED:42961958", "source": "europepmc", "url": "https://europepmc.org/article/MED/42961958" }, { "first_seen": "2026-11-03T12:22:43Z", "native_id": "PMC13722166", "source": "pmc", "url": "https://doi.org/10.1371/journal.pone.0361933" } ], "subjects": [ { "field": "medicine", "origin": "heading:Epidemiology", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "plos:oncology", "subfield": "oncology" }, { "field": "medicine", "origin": "heading:Surgical and Invasive Medical Procedures", "subfield": "surgery" } ], "title": "Detection of potentially curable recurrence after colorectal cancer surgery in a real-world population", "title_text": "Detection of potentially curable recurrence after colorectal cancer surgery in a real-world population", "type": "peer-reviewed", "updated_at": "2026-11-03T12:22:43Z", "url": "https://research.draconitic.com/paper/6yh813atnqa63", "venue": "PLOS One", "versions": [] }