Prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer: impact of patterns of pelvic recurrence on curative resection

Park, Jea Kun; Kim, Young Wan; Hur, Hyuk; Kim, Nam Kyu; Min, Byung Soh; Sohn, Seung Kook; Choi, Young Deuk; Ahn, Joong Bae; Roh, Jae Kyung; Keum, Ki Chang; Seong, Joon Kyung

doi:10.1007/s00423-008-0391-6

Cited by 49 publications

(46 citation statements)

References 30 publications

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“…3). Several studies revealed a clear survival advantage for patients who were eligible for surgery in the case of recurrent rectal carcinoma [60,61,62,63,64] as well as for colon carcinoma [65,66]. Although recurrence apart from N2 situations or adjacent organ invasion may be rarely expected in intraperitoneal colon carcinoma, a considerable number of cases may present in large-volume centers.…”

Section: Recurrent Diseasementioning

confidence: 99%

Surgery for Colorectal Cancer - Trends, Developments, and Future Perspectives

et al. 2016

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Background: Although colorectal surgery is long established as the mainstay treatment for colon cancer, certain topics regarding technical fine-tuning to increase postsurgical recurrence-free survival have remained a matter of debate throughout the past years. These include complete mesocolic excision (CME), treatment strategies for metastatic disease, significance of hyperthermic intraperitoneal chemotherapy (HIPEC), and surgical techniques for the treatment of colorectal cancer recurrence. In addition, new surgical techniques have been introduced in oncologic colorectal surgery, and their potential to provide sufficiently radical resection has yet to be proven. Methods: A structured review of the literature was performed to identify the current state of the art with regard to the mentioned key issues in colorectal surgery. Results: This article provides a comprehensive review of the current literature addressing the above-mentioned current challenges in colorectal surgery. The focus lies on the impact of CME and, in relation to this, on lymph node dissection, as well as on treatment of metastatic disease including peritoneal spread, and finally on the treatment of recurrent disease. Conclusion: Uniformly, the current literature reveals that surgery aiming at complete malignancy elimination within multimodal treatment approaches represents the fundamental quantum leap for the achievement of long-term tumor-free survival.

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Section: Recurrent Diseasementioning

confidence: 99%

Surgery for Colorectal Cancer - Trends, Developments, and Future Perspectives

et al. 2016

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“…Bu hastalarda tam rezeksiyon oranı %10-67 arasında değişmektedir. [26][27][28] Bununla birlikte cerrai sonrası mortalite ve morbidite oranları sıra-sıyla %10 ve %50 gibi yüksek oranlardadır. [25,29] Pelvik lenf nodu nüks tedavisinde stereotaktik beden radyoterapisi seçenek olabilir mi?…”

Section: Discussionunclassified

Is stereotactic body radiotherapy a treatment option for pelvic recurrences?

Dağoğlu¹

2015

TJ Oncol

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KliNiK ÇalIŞma ORIGINAL ARTICLE oBJeCtIVeSWhen surgery is not adequate, stereotactic body radiotherapy (SBRT) has been used for recurrent cancers. We report the outcomes of case series with pelvic recurrences from colorectal cancer irradiated with SBRT. metHoDSRobotic Stereotactic Radiotherapy system was used. The dose fractionation scheme was individualized based on tumor volume and location and prior radiation dose. reSultSBetween February 2010 and December 2014, four patients were treated. Treatment regions were pelvic side wall for two patients and presacral for two patients. SBRT doses were 24 Gy in 3 fractions for three patients and 36.25 Gy in 5 fractions for one patient.One patient treated for pelvic side wall recurrence developed symptomatic noropathy at fist year. CoNCluSIoNLocal recurrence in pelvis after modern combined modality treatment for colorectal cancer is rare. However it presents a therapeutic dilemma when it occurs; often symptomatic and eventually life threatening. SBRT can be a useful modality in this setting.

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“…4,7,17,20,25,29,34,40,44,45,47 Included patients had undergone EBRT as part of the primary treatment in a median of 28% (range 0%-100%) of cases in 43 studies (Table 1). Previous radiotherapy dose was specified in 10 studies, 4,7,9,12,19,27,28,41,55,57 with a total dose ranging from 10 to 110 Gy. The median percentage of patients who underwent chemotherapy as part of the treatment for the primary tumour was 37% (range 0%-100%) in 21 evaluable studies (Table 1).…”

Section: Therapy For Primary Rectal Cancermentioning

confidence: 99%

Intentionally curative treatment of locally recurrent rectal cancer: a systematic review

Tanis

Doeksen

Lanschot

2013

cjs

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Intentionally curative treatment of locally recurrent rectal cancer: a systematic reviewBackground: There is a lack of outcome data beyond local recurrence rates after primary treatment in rectal cancer, despite more information being necessary for clinical decision-making. We sought to determine patient selection, therapeutic modalities and outcomes of locally recurrent rectal cancer treated with curative intent. Methods:We searched MEDLINE (1990-2010) using the medical subject headings "rectal neoplasms" and "neoplasm recurrence, local." Selection of cohort studies was based on the primary intention of treatment and availability of at least 1 outcome variable. Results:We included 55 cohort studies comprising 3767 patients; 8 studies provided data on the rate of intentionally curative treatment from an unselected consecutive cohort of patients (481 of 1188 patients; 40%). Patients were symptomatic with pain in 50% (796 of 1607) of cases. Overall, 3088 of 3767 patients underwent resection. The R0 resection rate was 56% (1484 of 2637 patients). The rate of external beam radiotherapy was 100% in 9 studies, 0% in 5 studies, and ranged from 12% to 97% in 37 studies. Overall postoperative mortality was 2.2% (57 of 2515 patients). Five-year survival was at least 25%, with an upper limit of 41% in 11 of 18 studies including at least 50 resections. We found a significant increase in reported survival rates over time (r 2 = 0.214, p = 0.007). Conclusion:More uniformity in treatment protocols and reporting on outcomes for locally recurrent rectal cancer is warranted. The observed improvement of reported survival rates in time is probably related to better patient selection and optimized multimodality treatment in specialized centres.

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Prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer: impact of patterns of pelvic recurrence on curative resection

Abstract: Patients with central recurrences have a high probability of curative resection. Disease-free survival less than 1 year and curative resection of local recurrence were independent prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer.

Cited by 49 publications

References 30 publications

Surgery for Colorectal Cancer - Trends, Developments, and Future Perspectives

Surgery for Colorectal Cancer - Trends, Developments, and Future Perspectives

Is stereotactic body radiotherapy a treatment option for pelvic recurrences?

Intentionally curative treatment of locally recurrent rectal cancer: a systematic review

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