Recurrence pattern of rectal cancer after surgical treatment. Analysis of 122 patients in a tertiary care center

Abstract

Survival in rectal cancer has been related mainly to clinical and pathological staging. Recurrence is by far the most challenging issue when surgical treatment of rectal cancer is concerned. This study aims to establish a recurrence pattern for rectal adenocarcinoma submitted to surgical treatment between March 2003 and July 2016. After exclusion criteria were applied, one hundred twenty two patients were analyzed. Global recurrence was found in 22% of them, while 13.1% have had local recurrence. Disease-free survival was 23.9 months, in average, and medium follow-up was 34.13 months, varying from 6 to 115 months. Recurrence, in literature, is usually between 3 and 35% in 5 years, and shows a 5-years survival rate of only 5%. Around 50% of cases, recurrence is local, confined to pelvis. This data followed literature in most aspects evaluated, although finding a high rate of local recurrence remains a challenge in the seek for better surgical outcomes.

Pattern of Rectal Cancer Recurrence Following Potentially Curative Surgical Treatment

“…Distant metastases arise predominantly in the lung and liver and affect 20 to 50% of patients. [7][8][9] With the improvement in staging assessment and more precise indication of neoadjuvant and adjuvant therapy, it has been possible to celebrate a decrease in local recurrence rates and an increase in survival. 7,8,10 Other factors, such as pelvic dissection, adequate surgical margin, complete mesorectal resection, and surgeon experience, should also be considered when evaluating recurrence.…”

“…Distant metastases arise predominantly in the lung and liver and affect 20 to 50% of patients. 7 8 9…”

CK1α-targeting inhibits primary and metastatic colorectal cancer in vitro, ex vivo, in cell-line-derived and patient-derived tumor xenograft mice models

“…With an incidence of 1,849,518 and mortality of 880,792, colorectal cancer (CRC) accounted for 10.2% and 9.2% of all new cancer cases and cancer-related deaths, respectively, for both sexes, globally in the 2018 alone, thus, ranking as the third most diagnosed and second most fatal malignancy in the world (1,2). Regardless of the significant advances made in CRC diagnosis and documented progression in the effectiveness of contemporary multimodal anti-CRC therapeutic strategies in the last 3 decades, however, their off-target toxicity against rapidly-dividing colorectal cells and acquisition of resistant phenotype continue to limit achievement of optimal therapeutic effect; thus, CRC remains associated with poor clinical outcome, with high rates of metastasis and recurrence, and relatively low overall survival (OS) in advanced-stage cases (3)(4)(5)(6)(7).…”