OBJECTIVES:

Since the frequency of recurrences is not well known across different early-stage tumours, a systematic review was conducted to assess the recurrence rates and overall survival (OS) of patients diagnosed with early-stage cancers.

METHODS:

A search was conducted in Embase® and MEDLINE® between May 2012 and May 2022 to identify observational studies evaluating recurrence rates and OS among adult patients with melanoma, triple negative breast cancer (TNBC), non-small cell lung cancer (NSCLC), renal-cell carcinoma (RCC), gastric cancer, head and neck cancer (HNC), and bladder cancer.

RESULTS:

In the 131 included studies, recurrence rates were reported by 29, 28, 27 and 22 studies for patients diagnosed with HNC, melanoma, TNBC, and bladder cancer, respectively. Limited evidence was identified for other cancer types. Recurrence rates varied by cancer type and stage. For the overall population, the recurrence rates ranged from 12.9-42.5% for TNBC, 13-44% for melanoma, 24.3-33% for NSCLC, and 20-22% for RCC. A significantly higher recurrence rate of 67.6% was observed in stage III cutaneous melanoma patients vs. 42.9% in stage I-II patients. In patients with salivary gland cancer, overall recurrence rate was 26.5%, while in stage III-IV patients it was reported to be 51.7%. The evidence for OS in recurrent patients was very sparse and was identified only in melanoma, NSCLC, TNBC, bladder and HNC. A post-recurrence survival advantage was observed in locoregional recurrences compared with distant recurrences (p<0.05), as observed in melanoma, TNBC and HNC patients. In one study, patients diagnosed with early-stage HNC who did not experience recurrences had increased OS compared to patients with recurrences, although some conflicting evidence was also identified.

CONCLUSIONS:

Overall, patients diagnosed at earlier stages experience lower recurrence rates than those diagnosed at later stages. Among patients experiencing recurrences, those with locoregional recurrence had increased OS compared to patients experiencing distant metastases.