Local recurrence after potentially curative resection for rectal cancer in a series of 1008 patients

Abstract

Local recurrence and its related mortality after potentially curative resection for rectal cancer have been analysed in a series of 1008 patients managed by one of the authors. Nine hundred and thirty-four were available for analysis of recurrence. One hundred and seven (11 per cent) patients developed local recurrence without evidence of systemic spread and 84 (9 per cent) both local and systemic recurrence. Local recurrence was less common (14 per cent) after resection of tumours of the upper third of the rectum compared with the middle (21 per cent) (P = 0.02) or lower thirds (26 per cent) (P less than 0.001). Local recurrence was related to both tumour stage and differentiation (P less than 0.001). There was no significant relationship between local recurrence and tumour size or the type of curative resection performed, restorative or non-restorative. The distal margin of clearance after restorative resection did not influence the local recurrence rate. Of patients who developed metastases recurrence was evident within 2 years in 60 per cent. Three hundred and thirty-two patients died from recurrence, 91 (27 per cent) with evidence of local recurrence only, 80 (24 per cent) with combined local and systemic recurrence and 161 (48 per cent) with evidence of systemic spread only. The corresponding median survivals were 35, 34 and 39 months.

Is the 1-cm Rule of Distal Bowel Resection Margin in Rectal Cancer Based on Clinical Evidence? A Systematic Review

“…The remaining 17 studies constituted the material for the current review. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Only one report prospectively explored the issue in question as the secondary end point. 20 The remaining reports were retrospective.…”

“…In the remaining 15 studies the difference in local recurrence rate between the short margin group and to the long margin group was not significant in univariate analysis. [7][8][9][10][11][12][13][15][16][17][19][20][21][22][23] Of the eight reports showing long-term survival, survival did not differ statistically between the two groups in seven; in one remaining study survival was lower in the short margin group compared to the long margin group ( Table 1).…”

Recidiva pélvica de adenocarcinoma de reto: abordagem cirúrgica

“…Adicionado a este fato, além da radio e quimioterapia paliativas, existe apenas a ressecção cirúrgica como opção de cura da doença. (7,14,15) A sobrevida após a cirurgia para ressecção de recidiva pélvica foi de 34,6% em 29,4 meses de seguimento. Estes resultados foram semelhantes aos da literatura, na qual se pode encontrar taxas de sobrevida em cinco anos variando de 18 a 58%.…”

“…(11,14) Aproximadamente 50% dos doentes com recidiva pélvica de adenocarcinoma retal apresentam o tumor apenas na pelve, sem evidência de metástases à distância, e são potenciais candidatos para a excisão cirúrgica. (15,16,17,18) O procedimento cirúrgico pode envolver exenteração pélvica total até sacrectomia, devendo ser realizado por equipe cirúrgica habilitada e em casos selecionados. (19,20,21) O objetivo deste estudo foi analisar os casos de recidiva pélvica operadas pelo Grupo de Coloproctologia -Unicamp, destacando os aspectos clínicos, cirurgias realizadas e seguimento dos doentes.…”

Comparing colorectal cancer treatment and survival for Aboriginal and non‐Aboriginal people in New South Wales

“…McDermott et al 57 had 505 anterior resection patients and assessed the distal margin in 1-cm increments (<1 cm, 13 patients; 1-2 cm, 37 patients; 2-3 cm, 88 patients; 3-4 cm, 132 patients; 4-5 cm 89 patients; 5-6 cm, 72 patients; >6 cm, seven patients), but there was no difference in local recurrence among the groups (23%, 22%, 16%, 25%, 16%, 15% and 20% respectively). 58 looked at 243 anterior resection cases.…”