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Phenotype submission - local recurrence following colorectal cancer

Cohort Definition Name: Local recurrence after colorectal cancer
Contributor name: Andreas Weinberger Rosen
Contributor OrcId: 0000-0001-9990-8155
Logic Description: First event local recurrence after colorectal cancer
Recommended study application: Outcome, indication. Intended to be used after intended radical treatment of colorectal cancer.
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
local recurrence after colorectal cancer.txt (1.8 KB)

Target Clinical Description

Local recurrence after colorectal cancer refers to the return of malignant growth at or near the original site of the primary tumor, following initial curative treatment. This event can occur months to years after the initial treatment and signals a potentially challenging therapeutic landscape due to surrounding scar tissue and previous surgical alterations.

Presentation of Local Recurrence After Colorectal Cancer

Common presentations for local recurrence may include:

  • New or recurring symptoms similar to those experienced initially (e.g., rectal bleeding, altered bowel habits)
  • Pain or discomfort near the original surgical site or in the pelvis
  • Palpable mass on physical examination
  • Elevated levels of tumor markers such as carcinoembryonic antigen (CEA)

Assessment for Local Recurrence After Colorectal Cancer

  • Comprehensive imaging studies, including CT scans, MRI, or PET scans, to assess the extent and location of the recurrence
  • Biopsy of the suspected recurrent lesion for histopathological confirmation
  • Blood tests to assess general health and tumor markers
  • Review of previous surgical and medical treatment history

Differential Diagnosis of Local Recurrence After Colorectal Cancer

  • Postsurgical scar tissue or adhesions
  • Inflammatory conditions such as diverticulitis or inflammatory bowel disease
  • Benign growths like polyps or fibroids
  • Unrelated second primary cancers

Treatment Plan for Local Recurrence After Colorectal Cancer

Management strategies may include surgical resection if feasible, often with a more complex and extensive procedure than the initial surgery. Neoadjuvant or adjuvant therapies like chemotherapy, targeted therapy, or radiation may be employed to enhance surgical success and reduce the risk of further recurrence. For inoperable cases, palliative treatments such as chemotherapy or radiation therapy may be considered.

Prognosis for Local Recurrence After Colorectal Cancer

The prognosis varies widely depending on factors like the extent of the recurrence, the feasibility of surgical resection, and the patient’s overall health status. Generally, local recurrence poses a significant therapeutic challenge and is associated with a less favorable prognosis compared to initial diagnosis. However, aggressive multimodal treatments may offer a chance for long-term survival or even cure in select cases.

Assignment for Peer Review:

Peer review of the phenotype would be more than welcome

Imported to the OHDSI Phenotype Library. It may be expected to be found with id = 811 in the next release. Thank you