Outcome in Patients with Resectable Locally Recurrent Rectal Cancer After Total Mesorectal Excision with and Without Previous Neoadjuvant Radiotherapy for the Primary Rectal Tumor

Abstract

Surgical treatment of carefully selected patients with nonmetastasized resectable LRRC after nRTx and TME for the primary tumor is feasible and can result in sustained local control and overall survival. Patients with resectable LRRC who received nRTx for the primary tumor do not have a poorer outcome than patients who did not.

Endoscopic Ultrasound-Guided Fine Needle Aspiration Is Highly Accurate for the Diagnosis of Perirectal Recurrence of Colorectal Cancer

“…therefore, early diagnosis results in a better prognosis. 1,2 in most cases, the workup of a CRC recurrence includes an abdominal Ct scan or mRi and positron emission tomography scan. however, inflammatory changes around the anastomosis may mimic recurrence and turn out positive in the positron emission tomography scan.…”

Treatment of Locally Recurrent Rectal Carcinoma in Previously (Chemo)Irradiated Patients

“…nine studies were found suitable for this study. 11,13,[15][16][17][18][19][20][21] in these studies, a total of 474 lRRC patients were treated after previous (chemo)radiotherapy and surgical resection for their PRC.…”

“…in 3 of 9 studies, irradiation therapy was composed of only radiotherapy (n = 146) 13,15,16 ; chemoradiation only was given in 3 studies (n = 124), [17][18][19] and in the remaining 3 studies, either radiotherapy (n = 103) or chemoradiation (n = 93) was given. 11,20,21 in most studies, eBRt for the primary tumor was given preoperatively in 2 studies, 11,20 either preoperatively or postoperatively in 3 studies, 18,19,21 and the timing of eBRt was undefined in 4 studies, 13,[15][16][17] (preoperative, n = 203; postoperative, n = 66; unknown, n = 197).…”

“…the most frequently used surgical technique was low anterior resection (n = 228), abdominoperineal resection (n = 144), or either of those techniques (n = 104). 11,13,15,[17][18][19][20][21] in others, hartmann resection (n = 1), pelvic exenteration (n = 3), or transanal endoscopic microsurgery (n = 7) was performed. 11 for the remainder of the patients, surgical technique in PRC was not specified (n = 9).…”

Is stereotactic body radiotherapy a treatment option for pelvic recurrences?

“…[6] Diğer taraftan %68 gibi yük-sek oranlara ulaşan ameliyat sonrası komplikasyon oranları bildirilmiştir. [7][8][9][10][11][12] Kemoterapi (KT) ve eksternal radyoterapi (EBRT) sadece palyatif fayda sağlamaktadır. [13][14][15][16] Konvansiyonel EBRT ile yüksek dozlara ulaşmak pelviste bağırsak ve mesane gibi normal dokuların doz sınırlayıcı etkisi nedeniyle riskli olabilir.…”