Surgical resection of locally recurrent colorectal adenocarcinoma

Delpero, Jean‐Robert; B, Pol; Treut, Y. P. Le; Bardou, Valérie‐Jeanne; Moutardier, Vincent; Hardwigsen, Jean; F, Granger; Houvenaeghel, Gilles

doi:10.1046/j.1365-2168.1998.00583.x

Cited by 48 publications

(36 citation statements)

References 28 publications

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“…Therefore, these invasive procedures should only be considered in carefully selected patients. Although significant prognostic factors influencing the outcome of surgery for local recurrence have been identified, such as postoperative tumor marker levels and pathological curativity of surgical margins [17, 18], recognizable factors after surgery are not useful in determining the indications for surgery. As a result, factors which can be found preoperatively must be identified.…”

Section: Introductionmentioning

confidence: 99%

Doubling Time of Carcinoembryonic Antigen Is a Significant Prognostic Factor after the Surgical Resection of Locally Recurrent Rectal Cancer

Noura¹,

Ohue²,

Seki³

et al. 2008

Dig Surg

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Background: Patients undergoing a curative rectal cancer resection have a risk of developing locoregional recurrence. A curative resection for local recurrence is the option of improvement in prognosis. However, a curative resection is sometimes too invasive and should be considered in selected patients. Methods: A total of 43 patients with locally recurrent rectal cancer who had been treated by operation between 1989 and 2007 were retrospectively reviewed and the factors, including doubling time of carcinoembryonic antigen (CEA-dt), were analyzed. Results: The 5-year overall survival rate after the operation for local recurrence was 50.8%. Gender, presence of distant metastasis, tumor size, CEA-dt and curability were found to be significant prognostic factors. A multivariate analysis demonstrated the presence of distant metastasis, CEA-dt and tumor size to be significant prognostic factors for overall survival. The 5-year overall survival rates of patients with a CEA-dt ≧150 days and a tumor size <5 cm were 76.9%. Conclusions: The tumor size and CEA-dt were useful prognostic factors that were recognizable before surgery. Patients with locally recurrent rectal cancer with a CEA-dt ≧150 days and a recurrent tumor size <5 cm are considered to be good candidates for surgery.

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Section: Introductionmentioning

confidence: 99%

Doubling Time of Carcinoembryonic Antigen Is a Significant Prognostic Factor after the Surgical Resection of Locally Recurrent Rectal Cancer

Noura¹,

Ohue²,

Seki³

et al. 2008

Dig Surg

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“…De stadiul clinic al tumorii şi de radicalitatea chirurgiei depinde supravieţuirea la 5 ani, fiind de 77,6% pentru absenţa tumorii reziduale (R 0 ) şi de 45,7% pentru prezenta tumorii reziduale confirmate microscopic (R 1 ), comparativ cu 3,8% pentru prezenţa macroscopică a tumorii reziduale (R 2 ), de 0% pentru leziunile nerezecate [28]. Recidiva este mai frecventă după operaţiile incomplete, de 36% faţă de rezecţiile radicale, de 17% [12,34,36]. Recidiva depinde şi de gradul de penetrare al peretelui colic de către tumoră, variind între 0-1% pentru pT 1 , faţă de 17-44% pentru pT 2 [14].…”

Section: Discuţiiunclassified

“…prezenţa metastazelor în nodulii limfatici regionali din stadiul clinic III se însoţeşte de supravieţuirea la 5 ani de 50% pentru pN 1 şi de 34% pentru pN 2 . Prezenţa metastazelor în nodulii limfatici regionali din stadiul clinic III se asociază supravieţuirii la cinci ani cu 50% pentru N 1 şi cu 34% pentru N 2 [12][13][14]20,[29][30][31][32][33][34][35][36]. Într-un studiu pe 2400 pacienţi, supravieţuirea la cinci ani a fost de 82,3% şi de 70,2% la zece ani, pentru stadiul I, dar a scăzut în stadiul III, pentru aceleaşi perioade la 48,8% şi respectiv 38,7% [27].…”

Section: Discuţiiunclassified

“…Clasificarea TNM în care se ia în considerare numărul nodulilor limfatici regionali cu metastaze, are valoare predictivă mai mare decât clasificarea Dukes [27]. Analizele multivariate arată că metastazele în nodulii limfatici regionali au valoare statistică semnificativă pentru supravieţuire [4,12,20,22,27,[31][32][33][34][35][36][37][38][39][40][41]. Detalii ale supravieţuirii în funcţie de numărul nodulilor limfatici cu metastaze, aduce…”

Section: Discuţiiunclassified

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Metastatic Lymphadenopathy in Colon Cancer

Păunescu¹,

Pop-Began²,

Pop-Began³

et al. 2013

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METASTATIC LYMPHADENOPATHY IN COLON CANCER (Abstract): INTRODUCTION:The incidence and prevalence of colon cancer is increasing in the last decades, in Romania. The aim of this paper is to evaluate the place of metastatic lymphadenopathy as risk factor for postoperative morbidity and mortality. MATHERIAL AND METHODS: We perfomed a prospective study; 126 patients with colon cancer were included and prospectively reviwed. RESULTS: The men / women ratio was 70 / 56. The mean age was 65.26 years old (range 20-89 years). Most cases were in stage III (n=72, 57.14%) and IV (n=49, 38.89%) with tumors located more frequently on the left colon (n=86, 68.25%) and especially on the sigmoid colon (n=64, 50.79%). 33.33% patients (n=42) were operated in emergency. Colic wall invasion depth (pT 3 =49, 38.9%, pT 4 =72, 57.1%) were accompanied by an increase in the number of affected regional lymph nodes (pN 1 =29, 23.0%, pN 2 =43, 34.1%). Postoperative complications occurred only in patients in stages III (n=11, 15.41%) and IV (n=15, 30.61%). The 30 days postoperative mortality rate was 19.04% (n=24), mostly in stage pT 4 tumors (n=18, 25%). Metastatic adenopathy was found as risk factor for postoperative mortality rate: 16.66% (n=4) deaths for pN 1 , 30.23% (n=13) for pN 2 and resoectively 13.07% (n=7) mortality rate for pN 0 . The five years survival rate was 100% for stage I, 59.64% for stage II, 33.57% for stage III and nul for stage IV. CONCLUSIONS: The presence of metastatic adenopathy is crucial in assessing the informational value of early and late postoperative evolution.

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“…However, once isolated local recurrence is diagnosed only a minority of patients present with resectable disease [8]. The proportion of patients that can be cured by repeated surgery depends on several factors, of which resection with free margins, female sex, absence of pelvic pain prior to surgery, and intraluminal recurrence have been identified as most important favourable predictors [9][10][11]. In retrospective series, resectability rates up to 30% have been reported, with a maximum of 35% of long-term survivors [12][13][14].…”

Section: Surgerymentioning

confidence: 99%

Treatment of Locally Recurrent Rectal Cancer with Special Focus on Regional Pelvic Hyperthermia

Hildebrandt

Wust²,

Gellermann³

et al. 2004

Oncol Res Treat

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Progress in surgery and adjuvant therapy has markedly improved local control and survival rates in patients with primary, non-metastatic rectal cancer. However, the prognosis of patients with locally recurrent disease is still poor, and a realistic chance for repeated treatment with curative intent is still restricted to the minority of cases. Therefore, effective palliation of symptoms and preservation of a good quality of life are the major goals of therapy for most patients with local recurrence of rectal cancer. Here we give a short overview on the options available for the treatment of pelvic recurrence of rectal cancer, with special focus on adjunctive regional pelvic radiofrequency hyperthermia.

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Surgical resection of locally recurrent colorectal adenocarcinoma

Abstract: The results in this highly selected group seem to justify an attempt at reresection whenever possible. Long-term results may be improved by using adjuvant treatment.

Cited by 48 publications

References 28 publications

Doubling Time of Carcinoembryonic Antigen Is a Significant Prognostic Factor after the Surgical Resection of Locally Recurrent Rectal Cancer

Doubling Time of Carcinoembryonic Antigen Is a Significant Prognostic Factor after the Surgical Resection of Locally Recurrent Rectal Cancer

Metastatic Lymphadenopathy in Colon Cancer

Treatment of Locally Recurrent Rectal Cancer with Special Focus on Regional Pelvic Hyperthermia

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