Operative Salvage for Locoregional Recurrent Colon Cancer After Curative Resection: An Analysis of 100 Cases

Bowne, Wilbur B.; Lee, Byrne; Wong, W. Douglas; Ben-Porat, Leah; Shia, Jinru; Cohen, Alfred M.; Enker, Warren E.; Guillem, José G.; Paty, Philip B.; Weiser, Martin R.

doi:10.1007/s10350-004-0881-8

Cited by 125 publications

(112 citation statements)

References 25 publications

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“…Detecting recurrent disease is only useful if early treatment leads to an improved prognosis. Although the majority of relapsing patients are incurable, around one third of patients with isolated distant or locoregional recurrence are alive at 5 years after treatment, and long-term survival is possible [21,[23][24][25][26][27][28][29][30][31][32][33] . Rates of resection for isolated or limited disease recurrence have increased, and approximately 20% of patients with hepatic relapse are currently considered for surgery [24,32,34] .…”

Section: Introductionmentioning

confidence: 99%

Surveillance of patients following surgery with curative intent for colorectal cancer

Gan

Wilson²,

Hollington³

2007

WJG

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Surveillance after resection of colorectal cancer with curative intent is an important component of postoperative care. Clinical review, imaging, colonoscopy, and cost to the community are among significant issues to consider in planning a surveillance regime. This review aims to identify the available evidence for the use of surveillance and its individual components. The literature pertaining to follow-up of patients following potentially curative surgery for colorectal cancer was reviewed in order to formulate a summary of the wide range of clinical practice. There is evidence of improved survival of patients undergoing more intense follow-up compared with those having minimal surveillance, with an estimated overall 5-year gain of up to 10%. The efficacy of individual components of follow-up regimes remains unclear, but an overall package of 'intensive' follow-up including clinical review, liver imaging, and colonoscopy appears to be of benefit. It is cost-effective and can be specialist or community-based.

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Section: Introductionmentioning

confidence: 99%

Surveillance of patients following surgery with curative intent for colorectal cancer

Gan

Wilson²,

Hollington³

2007

WJG

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“…Recently, Min et al [12] categorized PALN recurrence as a retroperitoneal recurrence, which is a type of locoregional recurrence. Furthermore, several studies [13][14][15][16] have investigated the therapeutic efficacies of surgery for retroperitoneal, intraabdominal, and PALN recurrences, and several reported outstanding survival rates, which appear to have resulted from the selection of patients with a resectable mass at time of recurrence. In these studies, reported 5-year survival rates approached a maximum of 56% after complete resection, whereas they ranged from 0% to 7% after incomplete resection (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Stereotactic body radiotherapy for isolated paraaorticlymph node recurrence from colorectal cancer

Kim¹,

Cho²,

Yang³

et al. 2009

WJG

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AIM:To evaluate the efficacy and complications of stereotactic body radiotherapy in localized paraaortic lymph node recurrence from colorectal cancer. From 2003From to 2009 patients with paraaortic lymph node recurrence (1-3 lesions) from colorectal cancer were treated with stereotactic body radiotherapy. Total gross tumor volumes ranged from 4 to 40 mL. The doses were escalated from 36 Gy/patient to 51 Gy/patient and were delivered in 3 fractions. METHODS: RESULTS:One and 3 year overall survival rates were 100% and 71.4%, respectively, and median survival was 37 mo. Grade Ⅳ intestinal obstruction was reported in 1 of 7 patients. This patient received 48 Gy in 3 fractions with a maximum point dose to the intestine of 53 Gy and V45Gy = 3.6 mL. However, 6 patients received an intestinal maximum point dose of < 51 Gy and V45Gy of < 1 mL, and did not develop any severe complications. CONCLUSION:This pilot study suggests selected paraaortic lymph node recurrence (1-3 closed lesions) that failed to respond to chemotherapy can be potentially salvaged by stereotactic body radiotherapy.

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“…For the aforementioned reasons, the results of surgical treatment for these patients are difficult to analyze because some papers specifically report the results obtained for socalled locoregional recurrence whereas others refer to cytoreductive surgery (usually combined with intraoperative chemotherapy) for peritoneal metastases insofar as the two clinical conditions usually coexist. Two of the largest series describing attempted salvage surgery for locoregional recurrences from colon cancer reported by the Memorial Sloan Kettering Cancer Center and by the Netherland Cancer Registry [57,68], showed a Kaplan-Meier 5-year survival rate between 25 and 40 %. Peritoneal spread from colorectal cancer has long been regarded as a terminal condition carrying a dismal prognosis.…”

Section: Proactive Management Of Peritoneal Metastases From Colorectamentioning

confidence: 99%

Proactive Management for Gastric, Colorectal and Appendiceal Malignancies: Preventing Peritoneal Metastases with Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Sammartino

Biacchi

Cornali

et al. 2016

Indian J Surg Oncol

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An integrated treatment strategy using peritonectomy procedures plus hyperthermic intraperitoneal chemotherapy (HIPEC) is now a clinical standard of care in selected patients with peritoneal metastases and primary peritoneal tumors. This comprehensive approach can offer many patients, who hitherto had no hope of cure, a good quality of life and survival despite limited morbidity. The increasingly successful results and chance of interfering in the natural history of disease has prompted research to develop for some clinical conditions a therapeutic strategy designed to prevent malignant peritoneal dissemination before it becomes clinically evident and treat it microscopically (tertiary prevention). The main factor governing successful cytoreductive surgery and predicting outcome is the extent of peritoneal spread assessed with the peritoneal cancer index (PCI). In peritoneal metastases from colorectal and gastric cancer the PCI score acquires a specific role acting as the cut-off between patients who can undergo curative surgery or palliation. Long-term results show that the only group enjoying favorable results are patients with limited disease (a statistical minority). By applying to appropriately selected patients with primary malignancies a proactive management strategy including HIPEC we can treat patients with microscopic peritoneal dissemination and therefore at PCI 0. Among treated conditions pseudomyxoma peritonei enjoys the best results. But a major future advance comes from identifying among lesions at major risk of pseudomyxoma.

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Operative Salvage for Locoregional Recurrent Colon Cancer After Curative Resection: An Analysis of 100 Cases

Cited by 125 publications

References 25 publications

Surveillance of patients following surgery with curative intent for colorectal cancer

Surveillance of patients following surgery with curative intent for colorectal cancer

Stereotactic body radiotherapy for isolated paraaorticlymph node recurrence from colorectal cancer

Proactive Management for Gastric, Colorectal and Appendiceal Malignancies: Preventing Peritoneal Metastases with Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

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