['Apoptotic protease activating factor-1 (APAF-1) is a key regulator in the mitochondrial apoptotic pathway and an important diagnostic and therapeutic biomarker. Loss of APAF-1 expression has been observed in various tumors including colorectal cancer. The aim of our study was to evaluate the relationship between loss of APAF-1 expression and early recurrence of stage I-III colorectal cancer.', 'We investigated 165 out of 492 patients who had undergone curative resection for colorectal cancer between 1991 and 2001. Sixty-one patients (37.0\xa0%) had early recurrence within 1\xa0year after surgery. Tissue microarrays were used for immunohistochemical detection of APAF-1.', 'The mean age of patients with recurrence was 58\xa0years (range, 24-85); 88 (53.3\xa0%, 88/165) were male. APAF-1 was expressed in 32 (19.4\xa0%, 32/165) cases and was not expressed in 133 (80.6\xa0%, 133/165). In univariate analysis, early recurrence significantly correlated with loss of APAF-1 expression (p\u2009=\u20090.017), tumor stage (p\u2009=\u20090.005), N category (p\u2009=\u20090.001), and lymphatic invasion (p\u2009=\u20090.008). In a logistic regression model, loss of APAF-1 expression (p\u2009=\u20090.015, 95\xa0% CI\u2009=\u20091.280-10.063) and N category (p\u2009=\u20090.001, 95\xa0% CI\u2009=\u20090.004-0.739) proved to be independent risk factors associated with early recurrence. In patients with lymph node metastasis, early recurrence was more frequent in the APAF-1-negative group than in the APAF-1-positive group (46.2\xa0% (54/117) vs. 22.2\xa0% (6/27), p\u2009=\u20090.023).'] Is loss of APAF-1 expression associated with early recurrence in stage I , II , and III colorectal cancer?