Management of rectal cancer: the 2016 French guidelines

Lakkis, Zaher; Manceau, Gilles; Bridoux, Valérie; Brouquet, Antoine; Kirzin, Sylvain; Maggiori, Léon; Chaisemartin, Cécile de; Lefèvre, Jérémie H.; Panís, Yves

doi:10.1111/codi.13550

Cited by 74 publications

(53 citation statements)

References 56 publications

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“…Exclusion criteria were: patients treated by local excision, patients who received hormone therapy alone for prostate cancer, and those with synchronous rectal and prostate cancers. Preoperative assessment for rectal cancer included colonoscopy, pelvic MRI, and chest and abdominal CT.…”

Section: Methodsmentioning

confidence: 99%

Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy

Lakkis

Vernerey

Mège

et al. 2019

British Journal of Surgery

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Background Specific surgical and oncological outcomes in patients with rectal cancer surgery after a previous diagnosis of prostate cancer have not been well described. The aim of this study was to compare surgical outcomes in patients with rectal cancer with or without a history of prostate cancer. Methods Patients who had surgery for rectal cancer with (PC group) or without (no‐PC group) previous curative treatment for prostate cancer were enrolled between January 2001 and December 2015. Comparisons between the two groups were performed by multivariable Cox analysis, and after propensity score matching in a 3 : 1 ratio for demographic and tumour characteristics, and surgical and oncological outcomes. Results A total of 944 patients with rectal cancer were enrolled, of whom 10·8 per cent had a history of prostate cancer. After matching, 83 patients who had received treatment for prostate cancer were compared with 249 who had not. The PC and no‐PC groups were similar regarding patient characteristics. Extended total mesorectal excision, conversion to open surgery, transfusion and tumour perforation were more frequent in the PC group than in the no‐PC group. Major surgical morbidity (28 versus 17·2 per cent; P = 0·036), anastomotic leakage (25 versus 13·7 per cent; P = 0·019) and permanent stoma (41 versus 12·4 per cent; P < 0·001) occurred more frequently in the PC group. Local recurrence was increased significantly in the PC group (17 versus 8·0 per cent; P = 0·019), and resulted in a significant decrease in disease‐free and overall survival. Conclusion Prostate cancer treatment increases short‐ and long‐term surgical morbidity in patients with rectal cancer, and impairs oncological outcomes.

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Section: Methodsmentioning

confidence: 99%

Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy

Lakkis

Vernerey

Mège

et al. 2019

British Journal of Surgery

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“…3,4 However, this procedure is associated with high permanent stoma rates along with significant morbidity mainly due to anastomotic leakage (up to 17%) that can lead to chronic pelvic sepsis and low colovaginal and colovesical fistulas. 3,4 However, this procedure is associated with high permanent stoma rates along with significant morbidity mainly due to anastomotic leakage (up to 17%) that can lead to chronic pelvic sepsis and low colovaginal and colovesical fistulas.…”

Section: Introductionmentioning

confidence: 99%

What is the functional result of a delayed coloanal anastomosis in redo rectal surgery?

Boullenois

Lefèvre

Creavin

et al. 2019

ANZ Journal of Surgery

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Background: Delayed coloanal anastomosis (DCAA) may be used in patients with complex rectal conditions, such as chronic pelvic sepsis, low recto-vaginal and recto-vesical fistula; however, limited data are available. The aim is to report the morbidity and functional results of DCAA in redo rectal surgery. Methods: All patients undergoing DCAA between January 2014 and August 2017 were retrospectively included. Success was defined as a functional anastomosis without stoma, evaluated using the Low Anterior Resection Syndrome (LARS) score and the Gastrointestinal Quality of Life Index (GIQLI) functional assessment tools. Results: Of the 72 redo pelvic surgeries, 29 (40.3%) DCAA were performed over a 4-year period. Indications for redo resection were chronic pelvic sepsis (n = 13, 44.8%), rectovaginal fistula (n = 11, 37.9%) and recto-vesical fistula (n = 5, 17.2%). Mean interval period between the two procedures was 14 AE 3 days (8-21). Global major morbidity (Clavien-Dindo III or IV) was seen in six patients (20.7%). Stoma closure was feasible for 22 (75.9%) patients after a median period of 78 days (interquartile range 61-98). The 6-month success rate was 79.3%. Mean LARS was 28.8 AE 10.2 (3-41) (minor LARS) for 18 patients with no stoma at the end of follow-up. LARS score was significantly better with a follow-up >2 years (23.3 AE 12.2 versus 32.3 AE 7.9), P = 0.074. Mean GIQLI score was 79.2 AE 14.3 (48-98). Conclusions: Transanal colonic pull through with delayed anastomosis for redo-surgery in complex pelvic situations had low morbidity and avoided a permanent stoma in three out of four patients with an acceptable quality of life.

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“…Colorectal cancer is the third most commonly diagnosed cancer in men and the second in women [1]. In recent years, rectal cancer has developed into a comprehensive treatment mode mainly based on surgery, supplemented by radiotherapy and chemotherapy [2,3]. Laparoscopic rectal cancer surgery has been proven to have the same clinical results as traditional open surgery in terms of safety and e cacy [4,5].…”

Section: Introductionmentioning

confidence: 99%

Long-term oncologic outcomes of laparoscopic low anterior resection of rectal cancer with preservation of the left colic artery

Luo¹,

Li²,

Wu³

et al. 2020

Preprint

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Aim To analyze the effect of preserving the left colic artery (LCA) on long-term oncologic outcomes during laparoscopic low anterior resection of rectal cancer. Methods Clinicopathological and follow-up patients undergoing laparoscopic low anterior resection of rectal cancer in general surgery department of Guangdong Provincial People's Hospital from January 2014 to December 2015 were retrospectively collected. According to the difference surgical methods of inferior mesenteric artery (IMA), 159 cases were divided into the LCA preservation group and 225 cases in the LCA non-preservation group. The 5-year rates of overall survival (OS) and disease-free survival (DFS) were compared between two group. Results 384 patients were included in final analysis. Anastomotic leakage occurred in 7 patients (4.4%) in the LCA preservation group and in 16 patients (7.1%) in the LCA non-preservation group. The follow-up rate was 91.2% (145/159) during 5–60 months in LCA preservation group, and 89.8% (202/225) during 5–60 months in the LCA non-preservation group. The number of patients who developed death, local recurrence and metastasis were 59 (37.1%), 13 (8.2%) and 60 (37.7%) in the LCA preservation group, and 86 (38.2%), 20 (8.9%) and 92 (40.9%) in the LCA non-preservation group, without significant differences (all P ༞ 0.05). The 5-year OS and DFS rates were 69.0% and 59.3% in the LCA preservation group, and 68.8% and 55.9% in the LCA non-preservation group, without significant differences (all P ༞ 0.05). After stratification by TNM Stage, the difference on 5-year OS rates and DFS rates of I stage, II stage and III stage in two groups were no significant as well (all P ༞ 0.05). Conclusions The long-term oncologic outcomes of laparoscopic low anterior resection of rectal cancer with preservation of the LCA are comparable with ligation at origin of IMA.

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Management of rectal cancer: the 2016 French guidelines

Abstract: The current clinical practice guidelines are useful for the treatment of rectal cancer. Some statements require a higher level of evidence due to a lack of studies.

Cited by 74 publications

References 56 publications

Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy

Morbidity and oncological outcomes of rectal cancer impaired by previous prostate malignancy

What is the functional result of a delayed coloanal anastomosis in redo rectal surgery?

Long-term oncologic outcomes of laparoscopic low anterior resection of rectal cancer with preservation of the left colic artery

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