Resectable adenocarcinoma of the rectosigmoid and rectum. I. Patterns of failure and survival

Abstract

In an effort to determine the patterns of failure and survival of rectosigmoid and rectal cancer, a retrospective review of 168 patients who underwent potentially curative surgery at the New England Deaconess Hospital was performed. The 5-year actuarial survival for the entire group was 67%. Survival rates decreased with increasing penetration of the bowel wall by tumor and the presence of lymph node metastasis, but only the latter reached statistical significance. Those patients who underwent an abdominoperineal resection also experienced a significant decrease in survival compared to a low anterior resection. Patterns of failure, expressed as the actuarial incidence of first failure at 5 years, were examined by stage. With the exception of stages B3 and C3, there was a trend towards increased abdominal, distant, and total failure with increasing bowel wall penetration by tumor. A similar trend was seen in local failure in those patients with positive nodes. Knowledge of these data may help identify those patients who may benefit most from adjuvant therapy.

Recurrence Risk and Prognostic Parameters in Stage I Rectal Cancers

“…In stage I rectal cancer, standard approach is observation after the surgery because there was no benefit of chemotherapy and chemoradiotherapy in resulted trials. However, in this patient group, 5-year local recurrence rate varies between 10% and 40%, even if it depends on the surgical technique used (Minsky et al, 1988;Chakravarti et al, 1999;Mellgren et al, 2000). The efficacy of adjuvant chemotherapy or radiotherapy after the local excision are very scarce in randomized prospective studies in stage I rectal cancer (Weber et al, 1998).…”

Importance of tumor regression assessment in predicting the outcome in patients with locally advanced rectal carcinoma who are treated with preoperative radiotherapy

“…Rectal carcinoma is characterized by a high incidence of local recurrence (20 -70%), regional lymph node metastases, and distant metastases. 1,2 Major improvements have been made in the surgical control of local disease since the introduction of the so-called total mesorectal excision. 3,4 Nevertheless, the incidence of local recurrence remains high (10 -30%).…”

A retrospective comparison of preoperative MR staging and post-surgical pathology findings in patients with locally advanced rectal cancer treated with neoadjuvant chemotherapy.

“…Tek başına cerrahi ile lokal nüks oranları %20-50 olarak bildirilmektedir. Beş yıllık sağ kalım oranları yalnız cerrahi uygulanan T3-T4 rektal kanserlerde %44-60, lenf nodu tutulumu olduğu durumda ise %25-30 olarak verilmektedir (16,17) .…”