Long-Term Prognosis after Surgery for Locally Recurrent Rectal Cancer: A Retrospective Study

Abstract

Objective: Resection is usually recommended for locally recurrent rectal cancer (LRRC) for which R0 resection is possible, but its suitability varies by individual patient risk. Here, we report outcomes of resected LRRC in our hospital. Methods: We retrospectively evaluated short-and long-term results of 33 patients who underwent resections for LRRC from January 2003 to December 2019. Results: At the initial surgeries for these 33 patients, their disease stages at that time were Stage I: n=2, Stage II: n=12, Stage III: n=11, Stage IV: n=6, and unknown: n=2. Patients with Stage IV disease at their initial surgeries underwent radical one-step or two-step procedures. Metastasis to other organs was observed in 5 patients at the their initial LRRC diagnoses. At the LRRC surgeries, 7 patients received palliative surgeries; 26 received intent-to-treat resections, of which 17 were R0 resections. All-grade postoperative complications were observed in 11 patients, including 1 surgery-related death. Five-year overall survival rates were all cases: 38.4%; R0 group: 52.3%, R1 or R2 group: 19.4%, and palliative surgery group: 0%. The R0 group thus had significantly better prognosis than other patients (P = 0.0012). Eleven patients in the R0 group (64.7%) suffered re-recurrences but some patients achieved long-term survival through chemotherapy, radiation therapy, and surgery for metastasis to other organs, even after re-recurrence. Conclusion: Long-term prognosis after surgery for LRRC was significantly better for patients with R0 margins. Multimodal treatments may greatly improve survival for patients who suffer re-recurrences after local recurrence resections.

Correlation of Presacral Tumour Recurrence with Tumour Metastasis and Long-Term Tumour Recurrence Risk in Patients with Rectal Cancer

“…However, according to the previous statistics, patients with RC still face the risk of local recurrence after surgery. Studies have shown that the probability of recurrence in patients with RC has reached about 8–20% [ 10 ]. Especially, local recurrence will involve soft tissue and bony structure in front of the sacrum backward, which is presacral tumour recurrence.…”

Complete resection of a giant tumor in the ultralow rectum by a combination of transanal local excision and endoscopic submucosal dissection

“…Local recurrence is the main problem after ultralow rectal surgery 1 . Transanal local excision provides an adequate visual field at the anus and allows for good hemostasis of hemorrhoidal veins, but may leave residual lesions and cause perforation for lesions with severe fibrosis 2 3 .…”

PTEN and P-4E-BP1 might be associated with postoperative recurrence of rectal cancer patients undergoing concurrent radiochemotherapy

“…Previous studies showed that some clinicopathological features were associated with postoperative recurrence of rectal cancer [ 6 , 7 ]. Recently, studies on molecular markers related to radiochemotherapy sensitivity of cancers have been widely carried out [ 8 – 11 ], which might play a positive role in ameliorating the implementation of the ‘watch and wait’ strategy after neoadjuvant radiochemotherapy or promoting accurate implementation of adjuvant radiochemotherapy for locally advanced rectal cancer (LARC) patients.…”