Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study

Abstract

Background and Objectives: Despite advances in treatment, local recurrence remains a great concern in patients with rectal cancer. The aim of this study was to investigate the incidence and risk factors of local recurrence of rectal cancer in our single center over a 7-year-period. Materials and Methods: Patients with stage I-III rectal cancer were treated with curative intent. The necessity for radiotherapy and chemotherapy was determined before surgery and/or postoperative histopathological results. Results: Of 365 rectal cancer patients, 76 (20.8%) developed recurrent disease. In total, 27 (7.4%) patients presented with a local tumor recurrence (isolated in 40.7% of cases). Radiotherapy was performed in 296 (81.1%) patients. The most often used schema was 5 × 5 Gy followed by immediate surgery (n = 214, 58.6%). Local recurrence occurred less frequently in patients treated with 5 × 5 Gy radiotherapy followed by surgery (n = 9, 4%). Surgical procedures of relapses were performed in 12 patients, six of whom were operated with radical intent. Only two (7.4%) patients lived more than 5 years after local recurrence treatment. The incidence of local recurrence was associated with primary tumor distal location and worse prognosis. The median overall survival of patients after local recurrence treatment was 19 months. Conclusions: Individualized rectal cancer patient selection and systematic treatment algorithms should be used clinical practice to minimize likelihood of relapse. 5 × 5 Gy radiotherapy followed by immediate surgery allows good local control in resectable cT2N+/cT3N0 patients. Radical resection of isolated local recurrence offers the best chances of cure.

Pattern of Rectal Cancer Recurrence Following Potentially Curative Surgical Treatment

“…In the present study, it was the therapeutic choice in 35.5% of patients. 26 This study shows data similar to those of the literature in most respects, such as incidence of local recurrence and the site of distant recurrence. However, some results serve as a stimulus for the search for improvement in surgical and drug treatment to increase patients' disease-free survival.…”

The prevalence of back pain in patients operated on due to colorectal cancer depending on the type of surgical procedure performed

“…The average age of the study patients was slightly higher than 63 years and was typical for colorectal cancer patients [31]. The importance of reduced activity, especially within the elderly patients, was also highlighted by Ekblom-Bak et al, whose study of the compliance with physical activity recommendations within an elderly population showed that minimum physical activity requirements were met by as few as 7% of subjects [32].…”

The Prevalence of Back Pain in Patients Operated on Due to Colorectal Cancer Depending on the Type of Surgical Procedure Performed

“…Observations were carried out over a period of one year after surgery and should be treated as early results of the surgical treatment. Notably, the recurrence of colorectal cancer is most frequently observed within the first 2–3 years after surgical treatment, with early recurrences being uncommon [ 36 ]. On the other hand, pain, including low back pain, may be associated with local recurrence or spread of the disease [ 37 ].…”