Long-term outcomes following salvage surgery for locally recurrent rectal cancer: A 15-year follow-up study

Cyr, David P.; Zih, Francis S.W.; Wells, Bryan J.; Swett-Cosentino, Jossie; Burkes, Ronald L.; Brierley, James D.; Smith, Andrew; Swallow, Carol J.

doi:10.1016/j.ejso.2020.02.032

Cited by 12 publications

(20 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study demonstrated that preoperative CEA-DT >210 days was associated with a favorable prognosis after curative resection of LRRC, one of the few characteristic studies that have shown the clinical significance of CEA-DT to identify patients who are likely to benefit from surgical treatment. In line with the findings of previous retrospective cohort studies [2,[18][19][20], we also think that curative resection is a prerequisite for a favorable prognosis. Nevertheless, even after curative resection, the in-cidence of a second recurrence is high (54-66.7%) [3,21,22], and this often occurs early in the course of treatment.…”

Section: Discussionsupporting

confidence: 90%

Usefulness of Carcinoembryonic Antigen Doubling Time in Prognosis Prediction after Curative Resection of Locally Recurrent Rectal Cancer: A Retrospective Study

Sakamoto¹,

Ozawa²,

Nakanishi³

et al. 2021

Dig Surg

View full text Add to dashboard Cite

Introduction: Given that doubling time is an indicator of tumor growth, we assessed the usefulness of carcinoembryonic antigen doubling time (CEA-DT) in prognosis prediction after curative resection for locally recurrent rectal cancer. Methods: During January 1986 to December 2016, 33 patients with locally recurrent rectal cancer who underwent curative resection at our hospital were retrospectively reviewed. The primary endpoint was the 3-year recurrence-free survival (RFS) rate. The Kaplan-Meier method was used to compare RFS rates and evaluate univariate and multivariate analyses for factors associated with oncologic outcomes, including CEA-DT. CEA-DT was classified into two groups: the short and long CEA-DT groups. Results: The 3-year overall survival and RFS rates were 62.6% and 42.4%, respectively. In multivariate analyses, CEA-DT was an independent risk factor for poor RFS. The 3-year RFS rate was significantly better in the long CEA-DT group than in the short CEA-DT group (58.8% vs. 25.0%, p = 0.0063). Conclusion: CEA-DT is a useful prognostic factor that can be assessed before surgery for locally recurrent rectal cancer. Long CEA-DT may indicate a favorable prognosis. Contrarily, short CEA-DT is associated with poor prognosis; therefore, further treatment intervention is necessary for patients with short CEA-DT.

show abstract

Section: Discussionsupporting

confidence: 90%

Usefulness of Carcinoembryonic Antigen Doubling Time in Prognosis Prediction after Curative Resection of Locally Recurrent Rectal Cancer: A Retrospective Study

Sakamoto¹,

Ozawa²,

Nakanishi³

et al. 2021

Dig Surg

View full text Add to dashboard Cite

show abstract

“…However, the relatively small patient population in these studies could have resulted in less statistical power. A few small studies reported on the survival in patients with synchronous metastases specifically, presenting similar median OS rates compared with our study [17,18]. Previous work by our group showed a median OS of 27 months in LRRC patients with synchronous metastases [9].…”

Section: Discussionsupporting

confidence: 86%

Impact of a history of metastases or synchronous metastases on survival in patients with locally recurrent rectal cancer

et al. 2021

View full text Add to dashboard Cite

Aim Patients with locally recurrent rectal cancer (LRRC) frequently present with either synchronous metastases or a history of metastases. This study was conducted to evaluate whether LRRC patients without metastases have a different oncological outcome compared to patients with a history of metastases treated with curative intent or patients with potentially curable synchronous metastases. Method All consecutive LRRC patients who underwent intentionally curative surgery between 2005 and 2017 in a large tertiary hospital were retrospectively reviewed and categorized as having no metastases, a history of (curatively treated) metastases or synchronous metastases. Patients with unresectable distant metastases were excluded from the analysis. Results Of the 349 patients who were analysed, 261 (75%) had no metastases, 42 (12%) had a history of metastases and 46 (13%) had synchronous metastases. The 3‐year metastasis‐free survival was 52%, 33% and 13% in patients without metastases, with a history of metastases, and with synchronous metastases, respectively (P < 0.001) A history of metastases did not influence overall survival (OS), but there was a trend towards a worse OS in patients with synchronous metastases compared with patients without synchronous metastases (hazard ratio 1.43; 95% CI 0.98–2.11). Conclusion LRRC patients with a history of curatively treated metastases have an OS comparable to that in patients without metastases and should therefore be treated with curative intent. However, LRRC patients with synchronous metastases have a poor metastasis‐free survival and worse OS; in these patients, an individualized treatment approach to observe the behaviour of the disease is recommended.

show abstract

“…The treatment of locally recurrent rectal cancer (LRRC) remains a clinical challenge. Similar to primary rectal cancer, complete resection of LRRC is essential for improving both local control and long-term survival [ 5 ]. However, due to prior radiation and surgery, the normal surgical planes are disrupted, thus making it challenging to differentiate between fibrosis and recurrent malignancy.…”

Section: Introductionmentioning

confidence: 99%

Use of Image-Guided Surgical Navigation during Resection of Locally Recurrent Rectal Cancer

Groen

Hartog

Heerink

et al. 2022

Life

View full text Add to dashboard Cite

Surgery for locally recurrent rectal cancer (LRRC) presents several challenges, which is why the percentage of inadequate resections of these tumors is high. In this exploratory study, we evaluate the use of image-guided surgical navigation during resection of LRRC. Patients who were scheduled to undergo surgical resection of LRRC who were deemed by the multidisciplinary team to be at a high risk of inadequate tumor resection were selected to undergo surgical navigation. The risk of inadequate surgery was further determined by the proximity of the tumor to critical anatomical structures. Workflow characteristics of the surgical navigation procedure were evaluated, while the surgical outcome was determined by the status of the resection margin. In total, 20 patients were analyzed. For all procedures, surgical navigation was completed successfully and demonstrated to be accurate, while no complications related to the surgical navigation were discerned. Radical resection was achieved in 14 cases (70%). In five cases (25%), a tumor-positive resection margin (R1) was anticipated during surgery, as extensive radical resection was determined to be compromised. These patients all received intraoperative brachytherapy. In one case (5%), an unexpected R1 resection was performed. Surgical navigation during resection of LRRC is thus safe and feasible and enables accurate surgical guidance.

show abstract

Long-term outcomes following salvage surgery for locally recurrent rectal cancer: A 15-year follow-up study

Cited by 12 publications

References 42 publications

Usefulness of Carcinoembryonic Antigen Doubling Time in Prognosis Prediction after Curative Resection of Locally Recurrent Rectal Cancer: A Retrospective Study

Usefulness of Carcinoembryonic Antigen Doubling Time in Prognosis Prediction after Curative Resection of Locally Recurrent Rectal Cancer: A Retrospective Study

Impact of a history of metastases or synchronous metastases on survival in patients with locally recurrent rectal cancer

Use of Image-Guided Surgical Navigation during Resection of Locally Recurrent Rectal Cancer

Contact Info

Product

Resources

About