Presentation and prognosis of local recurrence after total mesorectal excision

Chaisemartin, Cécile de; Penna, Christophe; Goèré, Diane; Benoist, Stéphane; Beauchet, Alain; Julié, Catherine; Nordlinger, Bernard

doi:10.1111/j.1463-1318.2008.01537.x

Cited by 33 publications

(38 citation statements)

References 43 publications

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“…Durch Etablierung multimodaler Therapiekonzepte gelang eine weitere sig nifikante Verbesserung, die 5JahresLo kalrezidivrate im Prüfarm (prä operative Radiochemotherapie mit TME) der Mul ticenterstudie der German Rectal Cancer Study Group betrug knapp 6% [25]. Nach dem in der Vergangenheit postuliert wur de, dass etwa 80% aller Rezidive in den ersten 2 Jahren nach der Primäroperation auftreten, scheint sich unter TME und multimodaler Therapie eine Verschie bung zugunsten der Spätrezidive, z. T. nach über 10 Jahren, abzuzeichnen [6,9]. > Die Qualität der TME entscheidet über das Lokalrezidiv Rezidive an der seitlichen Beckenwand sind selten, Rezidive im hinteren zen tralen Becken dagegen häufig [13].…”

Section: Therapie Des Lokalrezidivs Nach Rektumkarzinomunclassified

Therapie des Lokalrezidivs nach Rektumkarzinom

2011

coloproctology

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Section: Therapie Des Lokalrezidivs Nach Rektumkarzinomunclassified

Therapie des Lokalrezidivs nach Rektumkarzinom

2011

coloproctology

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“…Es zeichnet sich ab, dass Lokalrezi dive nach standardisierter Voroperation einschließlich TME und multimodaler Vorbehandlung zukünftig weniger wahr scheinlich R0resektabel sind als Rezidive nach Voroperation mit begrenzter Radi kalität [2,6,18]. [19].…”

Section: Introductionunclassified

“…Durch Etablierung multimodaler Therapiekonzepte gelang eine weitere si gnifikante Verbesserung, die 5JahresLo kalrezidivrate im Prüfarm (präoperative Radiochemotherapie mit TME) der Mul ticenterstudie der German Rectal Can cer Study Group betrug knapp 6% [25]. Nachdem in der Vergangenheit postu liert wurde, dass etwa 80% aller Rezi dive in den ersten 2 Jahren nach der Pri märoperation auftreten, scheint sich un ter TME und multimodaler Therapie ei ne Verschiebung zugunsten der Spätrezi dive, z. T. nach über 10 Jahren, abzuzeich nen [6,9]. > Die Qualität der TME entscheidet über das Lokalrezidiv Rezidive an der seitlichen Beckenwand sind selten, Rezidive im hinteren zentra len Becken dagegen häufig [13].…”

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Therapie des Lokalrezidivs nach Rektumkarzinom

Hempen

Raab

2009

Chirurg

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During the last decade no gastrointestinal tumor underwent such profound modifications in diagnostics and therapy as rectal cancer (total mesorectal excision, multimodal therapy). Despite all efforts and continuous improvements in the results of oncological treatment, local recurrence of rectal carcinoma is still a considerable problem. Optimized surgery methods and multimodal therapies allow a local recurrence rate lowered to about 6%. Without surgical intervention the 5-year survival rate after local recurrence is approximately 4%, and the median survival time in a palliative situation is about 13 months and often associated with considerable restriction of quality of life. Morbidity after complex pelvic surgery is still high, but its mortality rate in highly professional surgical centers has reached an acceptable level of about 6%. Surgical oncology today has the ability for remarkable improvement in the prognosis of locally recurrent rectal cancer. After R0 resection the 5-year survival rate is nearly 30%.

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“…The authors used several selection criteria based on type of treatment for primary rectal cancer, characteristics of local recurrence, type of treatment for local recurrence and intraoperative findings. In 8 studies, 9,13,16,20,[42][43][44]54 the total number of patients undergoing treatment with curative intent from an unselected consecutive cohort of patients could be determined: 481 of 1188 patients (40%). The median period of patient inclusion was 13.3 (range 3.9-34) years in 51 studies (Table 1).…”

Section: Description Of Selected Cohortsmentioning

confidence: 99%

Intentionally curative treatment of locally recurrent rectal cancer: a systematic review

Tanis

Doeksen

Lanschot

2013

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Intentionally curative treatment of locally recurrent rectal cancer: a systematic reviewBackground: There is a lack of outcome data beyond local recurrence rates after primary treatment in rectal cancer, despite more information being necessary for clinical decision-making. We sought to determine patient selection, therapeutic modalities and outcomes of locally recurrent rectal cancer treated with curative intent. Methods:We searched MEDLINE (1990-2010) using the medical subject headings "rectal neoplasms" and "neoplasm recurrence, local." Selection of cohort studies was based on the primary intention of treatment and availability of at least 1 outcome variable. Results:We included 55 cohort studies comprising 3767 patients; 8 studies provided data on the rate of intentionally curative treatment from an unselected consecutive cohort of patients (481 of 1188 patients; 40%). Patients were symptomatic with pain in 50% (796 of 1607) of cases. Overall, 3088 of 3767 patients underwent resection. The R0 resection rate was 56% (1484 of 2637 patients). The rate of external beam radiotherapy was 100% in 9 studies, 0% in 5 studies, and ranged from 12% to 97% in 37 studies. Overall postoperative mortality was 2.2% (57 of 2515 patients). Five-year survival was at least 25%, with an upper limit of 41% in 11 of 18 studies including at least 50 resections. We found a significant increase in reported survival rates over time (r 2 = 0.214, p = 0.007). Conclusion:More uniformity in treatment protocols and reporting on outcomes for locally recurrent rectal cancer is warranted. The observed improvement of reported survival rates in time is probably related to better patient selection and optimized multimodality treatment in specialized centres.

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Presentation and prognosis of local recurrence after total mesorectal excision

Abstract: Half of the local recurrence after total mesorectal excision was located at the anastomotic site. Rectoscopic examination should be performed regularly to detect these anatomotic recurrences that are accessible to a R0 itérative resection.

Cited by 33 publications

References 43 publications

Therapie des Lokalrezidivs nach Rektumkarzinom

Therapie des Lokalrezidivs nach Rektumkarzinom

Therapie des Lokalrezidivs nach Rektumkarzinom

Intentionally curative treatment of locally recurrent rectal cancer: a systematic review

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