Clinical Predictors for Recurrence after Curative Resection for Colorectal Cancer

Røkke, Ola; Heggelund, Thomas; Benth, Jūratė Šaltytė; Røkke, Marianne Steffensen; Øvrebø, Kjell

doi:10.4236/jct.2017.812095

Cited by 2 publications

(2 citation statements)

References 35 publications

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“…The reoperation rate of 9.3% was similar to other studies, reporting reoperation rates of 5% -10% after rectal cancer surgery and leak rates in colorectal and colo-anal anastomoses of 5% -19% [19] [20]. In a previous study, reoperation after surgery for colorectal cancer was associated with increased frequency of cancer recurrence [21]. This is also supported by studies from Kulu et al and Ptok et al, reporting an increase in recurrence rate and reduced survival rate in patients with anastomotic leaks after curative resection for rectal cancer [22] [23].…”

Section: Discussionsupporting

confidence: 86%

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Røkke¹,

Heggelund²,

Benth³

et al. 2021

JCT

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Purpose: To identify clinical predictors for reduced long-term survival and describe the cause of death after surgical treatment for rectal cancer. Methods: A retrospective follow-up study of 442 consecutive, unselected patients treated for rectal cancer at a tertiary centre from 1990 until 2000 and followed for 17 years or until death. Predictors for death were assessed by Cox regression analysis. The cause of death was obtained from the Norwegian Cause of Death Registry. Results: 254 men and 188 women with a median age of 71 years (21-95 years) were resected for rectal cancer with low anterior resection (n = 266), abdominoperineal resection (n = 125), Hartmann's procedure (n = 19) or diverting stoma only (n = 32). Median follow-up was 5 years (0-17 years). The relative five-year survival rates for stages I, II, III and IV was 83.9%, 65.2%, 41.1% and 9.3%, respectively. The proportion of deaths due to recurrence from colorectal cancer in stages I, II, III and IV was 23.5%, 55.8%, 72.3% and 98.0%, respectively. Heart, lung and cerebrovascular disease and other malignancies were the cause of death in the other patients. Higher age, abdominoperineal resection compared to low anterior resection, lack of lymph node dissection compared to total mesorectal excision (TME), postoperative reoperations, TNM stages II and III compared to stage I and residual tumours after surgery were all significant independent predictors of reduced survival in the adjusted Cox regression model. Conclusions: Age, tumour stage, type of surgery, lymph node dissection, residual tumour after surgery and reoperations are predictors for survival after surgery for rectal can

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Section: Discussionsupporting

confidence: 86%

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Røkke¹,

Heggelund²,

Benth³

et al. 2021

JCT

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“…[10] The patterns and predictors of LR after curative resection have been investigated to optimize the therapeutic regimen and postoperative surveillance. Liska et al [11] proved that tumor stage, bowel obstruction, margin involvement, lymphovascular invasion, and local tumor invasion were significantly associated with colon cancer LR, and Rokke et al [12] further demonstrated that reoperation for postoperative complications, other than anastomotic leakage, was a significant predictor of LR of CRC. Although recent advances in molecular characterization of CRC have identified prognostic and predictive biomarkers for disease recurrence, [13][14][15] the pattern of genomic evolution between paired primary and LR CRC tissues and molecular evidence for the origin of recurrence are still unclear.…”

Section: Introductionmentioning

confidence: 99%

Genomic evolution during locoregional recurrence in colorectal cancer determined by whole-exome sequencing: a retrospective observational study

Lan

Zhang³

et al. 2022

J Bio-X Res

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Objective: The genomic landscapes of metastatic colorectal cancer (mCRC) have been extensively studied; however, the genetic mechanisms underlying the locoregional recurrence (LR) of CRC remain unclear. The objective of our study was to investigate genomic evolution during LR in CRC using high-throughput sequencing. Methods: Twenty-three CRC patients with matched primary and LR tissues were recruited from Nanfang Hospital and Zhejiang Cancer Hospital between January 2011 and December 2018. The last date of follow-up was March 2020. Tissue samples were analyzed by whole-exome sequencing and the genomic profiles were depicted by single nucleotide variation, mutational signature, copy number variation, clonal architecture, and other features. The evolutionary process was speculated with comparison of the genetic variations between primary and LR lesions. The disseminating clusters from primary to LR lesions were identified by variant allele frequency dynamics. Furthermore, the early-recurrent biomarker was explored by comparing the indel signature between early- and late-recurrent patients. The study was approved by the Institutional Review Board of Nanfang Hospital of Southern Medical University (approval No. 2020010) on September 11, 2020. Results: The results highlighted distinct origins of LR between patients with high microsatellite instability and microsatellite stability. LR lesions evolved independently in patients with high microsatellite instability, while LR lesions were highly clonally related to the primary lesions in patients with microsatellite stability. Late-acquired variations in LR lesions encompassed a wide range of driver genes involved in histone methylation, DNA replication, T cell activation, PDCD1 gain, and LMNA loss. Furthermore, clonal analysis of the disseminating cells identified a dominant polyclonal seeding pattern during LR. The indel signature ID4 was associated with significantly shorter disease-free survival in patients with relapsed CRC according to a public dataset. Conclusion: These findings pose a challenge for the development of new approaches targeting the interactions of multiple clones in the establishment of LR and in terms of optimizing the clinical management of susceptible patients.

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Clinical Predictors for Recurrence after Curative Resection for Colorectal Cancer

Cited by 2 publications

References 35 publications

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Genomic evolution during locoregional recurrence in colorectal cancer determined by whole-exome sequencing: a retrospective observational study

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