National Early Rectal Cancer Treatment Revisited

Stornes, Tore; Wibe, Arne; Nesbakken, Arild; Myklebust, Tor Åge; Endreseth, Birger Henning

doi:10.1097/dcr.0000000000000591

Cited by 44 publications

(44 citation statements)

References 25 publications

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“…Some studies have found no difference between local excision and TME surgery in local recurrence rates or outcomes of patients with T1 rectal cancer [7, 14, 29]. However, Stornes et al [6] studied 543 patients with T1 rectal cancer and reported that the local recurrence rate was 14.5% in patients who underwent transanal endoscopic microsurgery, which was significantly higher than the recurrence rate (1.4%) in patients who underwent TME ( p < 0.001). The 5-year OS rate was significantly lower in the transanal endoscopic microsurgery group (65.3%) than in the TME group (81.5%, p = 0.012).…”

Section: Discussionmentioning

confidence: 99%

“…The rate of local recurrence after local excision ranges from 11 to 18% [6-8, 10, 12-14, 26, 27]. In rectal cancer, 27% of metastatic lymph nodes were reported to be 3 mm or less in diameter.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of local recurrence has been reported to be relatively high after local excision alone [6-15]. However, local recurrence is almost completely inhibited by additionally administering chemoradiotherapy (CRT) after local excision [11, 16-18].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Local Excision plus Chemoradiotherapy in Patients with T1 Rectal Cancer

et al. 2018

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Objective: The National Comprehensive Cancer Network (NCCN) guidelines recommend local excision and observation as standard treatment for selected patients with clinical T1N0M0 rectal cancer. In patients with pathological T1 (pT1) rectal cancer who received local excision, the local recurrence rate is at least 10%. We studied oncological outcomes in patients with pT1 rectal cancer who received chemoradiotherapy (CRT) after local excision. Methods: Local excision was performed in 65 patients with clinical T1N0M0 rectal cancer (≤8 cm from the anal verge, tumor size < 30 mm, well or moderately differentiated adenocarcinoma). The patients received CRT (40 or 45 Gy in 1.8–2.0 fractions with concurrent oral UFT [tegafur/uracil] or S-1 [tegafur/gimeracil/oteracil]) after confirmation of pT1 and negative margins. Results: Patients who had pT2 cancer or who did not provide informed consent were excluded. The remaining 50 patients additionally received CRT. The CRT was completed in 48 patients (96%). The median follow-up period was 71 months. Local recurrence occurred in 1 patient (2%). Distant metastases occurred in 3 patients (6%). The 5-year disease-free survival rate was 86%, and the 5-year overall survival rate was 92%. Conclusions: Our study suggested that multidisciplinary treatment with local excision plus CRT can be used as a treatment option in selected patients with clinical T1N0M0 rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcomes of Local Excision plus Chemoradiotherapy in Patients with T1 Rectal Cancer

et al. 2018

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“…Registry studies show that fertility-sparing versus radical surgery for stage I ovarian cancer result in excellent (98%) 5-year survival rates in both groups, albeit with fewer recurrences in the former groups [47]. Optimal management of early-stage tumors is an area of debate where the registries have provided relevant data on favorable results in early-stage renal cell cancer and the use of transanal endoscopic microsurgery in T1 rectal cancer [28,48]. Clinical registry data can also be applied to build prediction models based on complex clinical information such as consultations, imaging, biomarkers and tumor data, to define patient groups that can be spared adjuvant treatment or need of intensified surveillance and/or rehabilitation [49][50][51][52][53][54][55].…”

Section: Monitoring Changing Principles Of Carementioning

confidence: 99%

The power of empirical data; lessons from the clinical registry initiatives in Scandinavian cancer care

Nilbert

Thomsen

Jensen³

et al. 2020

Acta Oncologica

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Background: In Scandinavia, there is a strong tradition for research and quality monitoring based on registry data. In Denmark, Norway and Sweden, 63 clinical registries collect data on disease characteristics, treatment and outcome of various cancer diagnoses and groups based on process-related and outcome-related variables. Aim: We describe the cancer-related clinical registries, compare organizational structures and quality indicators and provide examples of how these registries have been used to monitor clinical performance, develop prediction models, assess outcome and provide quality benchmarks. Further, we define unmet needs such as inclusion of patient-reported outcome variables, harmonization of variables and barriers for data sharing. Results and conclusions: The clinical registry framework provides an empirical basis for evidencebased development of high-quality and equitable cancer care. The registries can be used to follow implementation of new treatment principles and monitor patterns of care across geographical areas and patient groups. At the same time, the lessons learnt suggest that further developments and coordination are needed to utilize the full potential of the registry initiative in cancer care.

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“…Although there were not differences in distant metastases rates and overall survival, a higher risk of local recurrence was evidenced [9, 10]. Similarly, data from Norwegian Colorectal Cancer Registry show the absence of differences in 5-year relative survival rate but a significant lower 5-year local recurrence rate after total mesorectal excision [11]. …”

Section: Management Of Local Diseasementioning

confidence: 99%

SEOM Clinical Guideline of localized rectal cancer (2016)

et al. 2016

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Localized rectal adenocarcinoma is a heterogeneous disease and current treatment recommendations are based on a preoperative multidisciplinary evaluation. High-resolution magnetic resonance imaging and endoscopic ultrasound are complementary to do a locoregional accurate staging. Surgery remains the mainstay of treatment and preoperative therapies with chemoradiation (CRT) or short-course radiation (SCRT) must be considered in more locally advanced cases. Novel strategies with induction chemotherapy alone or preceding or after CRT (SCRT) and surgery are in development.

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National Early Rectal Cancer Treatment Revisited

Cited by 44 publications

References 25 publications

Outcomes of Local Excision plus Chemoradiotherapy in Patients with T1 Rectal Cancer

Outcomes of Local Excision plus Chemoradiotherapy in Patients with T1 Rectal Cancer

The power of empirical data; lessons from the clinical registry initiatives in Scandinavian cancer care

SEOM Clinical Guideline of localized rectal cancer (2016)

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