Clinical Algorithms for the Surgical Management of Locally Recurrent Rectal Cancer

Mirnezami, Alexander; Sagar, P. M.; Kavanagh, Dara; Witherspoon, Paul; Lee, Peter; Winter, D. C.

doi:10.1007/dcr.0b013e3181e10b0e

Cited by 81 publications

(61 citation statements)

References 57 publications

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“…Radical (R0) resection of LR is associated with at least twice higher survival than in non-radical (R1/R2) resection and remains the treatment of choice [21,22]. The tumor-free resection margin is a favorable prognostic factor for improved local control and overall survival [19][20][21][23][24][25][26]. In our study the survival time of patients after R0 resection was longer in comparison to non-radical resection group.…”

Section: Discussionmentioning

confidence: 57%

“…In our analysis, the staging of rectal cancer recurrence was assessed according to the modified Wanebo classification. The infiltration of side walls is associated with worse outcomes and obtaining radical resection is then significantly reduced [24,35]. Median survival in patients with M0, R0 resection with IORT and in stage Tr 1-4 of the Wanebo classification was 26 months.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

240. Intraoperative radiotherapy with low energy photons in recurrent colorectal cancer: A single centre retrospective study

Skórzewska

Jankiewicz

Mielko

et al. 2014

European Journal of Surgical Oncology (EJSO)

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

240. Intraoperative radiotherapy with low energy photons in recurrent colorectal cancer: A single centre retrospective study

Skórzewska

Jankiewicz

Mielko

et al. 2014

European Journal of Surgical Oncology (EJSO)

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“…[21][22][23] Cerrahi veya palyasyon bu durumda standart tedavi kabul edilirken [7,8,24] genellikle uygunlanabilir bir yöntem değildir. [25] Daha önce EBRT alsın ya da almasın bu hastalar için SBRT bir seçenek olarak gö-rülmektedir.…”

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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“…Lograr una resección R0 es el factor pronóstico más importante, independiente incluso del tipo de RL y se logra en alrededor del 50% de los pacientes intervenidos, es decir, alrededor del 20% del global de pacientes con diagnóstico de una RL 4,5,12,17,[20][21][22][23][24][25][26] . Se considera una contraindicación formal de cirugía de salvataje los pacientes con pelvis congelada con compromiso de la pared lateral, de la escotadura ciática, de los vasos ilíacos con edema de la extremidad, la invasión de S1-S2 y la presencia de enfermedad diseminada 27 .…”

Section: Factores Quirúrgicosunclassified

¿se Justifica El Tratamiento De La Recidiva Local Del Cáncer De Recto?

2014

Rev Chil Cir

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Treatment of local relapses of rectal cancerThe treatment of local relapses of rectal cancer requires a multimodal strategy. The preoperative assessment should consider the performance status of the patient, determine the precise anatomical involvement and look for distant metastases. The risk factors for a local relapse are the height of the tumor, the type of intervention, an elevated carcinoembryonic antigen in the preoperative period, the circumferential margin involvement and the stage of the tumor. The prognostic factors for an established local relapse are the type of surgery for the primary tumor (local excision, anterior or abdominoperineal resection), the type of relapse (staging), the presence of symptoms (profound pelvic pain) and specially the possibility of achieving a complete resection. A systematic analysis of 55 reports concluded that a radical resection with curative intention was achieved in 40% of cases. Preoperative external or intraoperative radiotherapy was used in 12 to 97% and 8 to 91% of cases respectively. Thirty days postoperative mortality was 2.2%, the rates of local control of the tumor ranged from 29 to 100% and five years survival was at least 25% with a superior limit of 41%. Although there are no clear guidelines for the management of these patients, there is a growing consensus in the use of preoperative radiotherapy to achieve better surgical results. Therefore a multimodal treatment of local relapses is justified.Key words: Rectal cancer, local relapse, surgery. ResumenEl tratamiento actual de la recidiva local (RL) del cáncer de recto representa un verdadero desafío para el equipo multidisciplinario que debe manejar esta seria complicación con una estrategia de terapia multimodal. La evaluación preoperatoria de la RL considera el status perfomance del paciente y busca establecer el compromiso anatómico preciso, así como descartar enfermedad a distancia. Entre los factores de riesgo para la ocurrencia de una RL destacan la altura del tumor (bajo), el tipo de intervención (RAP), el CEA preoperatorio elevado, la perforación intraoperatoria, el compromiso del margen circunferencial y el estadio del tumor

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Clinical Algorithms for the Surgical Management of Locally Recurrent Rectal Cancer

Cited by 81 publications

References 57 publications

240. Intraoperative radiotherapy with low energy photons in recurrent colorectal cancer: A single centre retrospective study

240. Intraoperative radiotherapy with low energy photons in recurrent colorectal cancer: A single centre retrospective study

Is stereotactic body radiotherapy a treatment option for pelvic recurrences?

¿se Justifica El Tratamiento De La Recidiva Local Del Cáncer De Recto?

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