Surgical resection of recurrent colonic cancer

Harji, Deena; Sagar, P. M.; Boyle, K; Griffiths, Ben; McArthur, D. Ray; Evans, M. D.

doi:10.1002/bjs.9113

Cited by 27 publications

(22 citation statements)

References 22 publications

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“…There are many data suggesting that the recurrence rate of colorectal cancer is higher in male gender. 4,5,7,10,16,20 In this series, more patients were male. However, no difference was found between R0 and R1 groups.…”

Section: Discussionmentioning

confidence: 64%

“…There are many studies on the surgical technique that can be performed in case of local recurrence and their outcomes. 3,4,5,6,7,8,9,10,11,12 The surgery varies greatly due to many variables such as the location of the tumor, affected organs, presence or absence of metastases and accompanying diseases of the patient. This complicates both the measurement and demonstration of perioperative outcomes and does not allow comparison of different treatment modalities.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have reported perioperative complication rates between 15% and 68%, and have reported that early mortality reaches 3%. 3,6,7,14,15,16,17,18 Especially in rectal cancer surgery, surgical margin positivity is an important problem and its relationship with local recurrence has been known for a long time. 19 On the other hand, due to the nature of the disease and the difficulty of surgery, it is not possible to achieve surgical margin negativity in the case of recurrence as much as primary disease surgery.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Recurrent Colorectal Cancer: Short and Long Term Outcomes

Okkabaz¹,

Öncel²

2019

tjcd

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Amaç: Nüks kolorektal kanser cerrahisi uygulanan hastalarda cerrahi sınır pozitifliğinin erken ve geç dönem sonuçlarını üzerine etkisini incelemektir. Yöntem: Nüks kolorektal kanser tanısıyla ameliyat edilen hastalarda cerrahi sınır pozitifliği durumuna göre demografik veriler, ilk hastalık ve operasyon bilgileri, nüks hastalık ve tedavi verileri ile uzun dönem sonuçları kıyaslandı. Bulgular: Nüks kolorektal kanser nedeniyle ameliyat edilen 57 hastanın küratif amaçlı rezeksiyonun başarıldığı 49'u (%86) çalışmaya dahil edildi. Bu olguların 11'inde (%22,4) patoloji raporlarında cerrahi sınır pozitifliği (R1) saptandı. R0 ve R1 grupları demografik veriler, ilk tümörün yerleşim ve evresi ile nükse kadar geçen süre, uygulanan onkolojik tedaviler açılarından istatistiki farklılık göstermiyordu. Uygulanan cerrahi işlemler nüks lezyonun yerleşimine göre farklılık göstermekle beraber oransal olarak gruplar arasında benzerdi. Operasyon süresi, ameliyat sırasında kanama miktarı, transfüzyon ihtiyacı ve miktarı ile hastanede kalış süreleri benzerdi (her bir değişken için p>0,05). R0 ve R1 gruplarında %44,7 (n=17) ve %36,4 (n=4) oranlarında postoperatif komplikasyon izlendi, ancak gruplar arasında farklılık gözlenmedi. R0 ve R1 gruplarında yer alan hastalarda yeniden bölgesel tekrarlama oranları %18,9 (n=7) ve %27,3 (n=3) idi (p=0,675). Hastaların 1, 3 ve 5 yıllık genel sağkalım oranları (%78,4 vs. %81,8, p=0,754; %43,2 vs. %36,4, p=0,720 ve %27,0 vs. %27,3, p=0,866) idi. Sonuç: Nüks kolorektal kanser ameliyatı sonrası komplikasyon oranları yüksektir. Bu çalışma nüks kolorektal kanser tanısı ile ameliyat edilen hastalarda mikroskobik cerrahi sınır pozitifliğinin (R1) erken ve geç dönem sonuçları olumsuz olarak etkilemeyebileceğini ve bu olguların lokal tekrarlama oranlarının tam rezeksiyon başarılan (R0) olgulara benzer olabileceğinin altını çizmektedir.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Recurrent Colorectal Cancer: Short and Long Term Outcomes

Okkabaz¹,

Öncel²

2019

tjcd

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“…Management of BM is still unclear and is usually determined by the extracranial disease progression and response to chemotherapy, since most of the patients die from their extracranial disease [14,15]. The management of locoregional recurrent colon cancer is more clearly defined, with surgical resection in appropriate candidates offering an opportunity for curative therapy [16,10].…”

Section: Discussionmentioning

confidence: 99%

Curative Intent Treatment for Colorectal Cancer with Isolated Brain Metastases: A Case Report

Cherfane¹,

Kapadia²,

Schey³

et al. 2014

J Carcinogene Mutagene

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Introduction: Brain metastases (BM) are a rare complication of colorectal cancer (CRC), typically presenting late in the course of the disease and are associated with other systemic metastases. Management of solitary brain metastases in colorectal cancer is still not well established. Case presentation: We describe the case of a 65 year-old man presenting with a solitary brain metastasis as the first sign of colon cancer. The treatment approach included surgical resection of the brain lesion followed by resection of the primary tumor, systemic chemotherapy and local radiation therapy to the BM. Conclusion: This curative intent approach has resulted in dramatically prolonged patient's survival compared to the average reported in the literature, now nearly 2.5 years after presentation. Our case describes the feasibility of a multidisciplinary curative intent approach to solitary BM in CRC.

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“…Cancer statistics in the United States as well as in Europe show that in the past 20 years the survival rates for rectal cancer have overtaken those for colon cancer [50,51]. Yet the criteria for defining and quantifying endoperitoneal recurrence in colon cancer remain unclear, some proposed classifications that leave the problem unsolved [52] and some investigators surprisingly considered peritoneal seeding or ovarian involvement after colonic resection as distant metastases [53]. If we accept the term Blocoregional recurrence^in resected colonic cancer defined in an aspecific way, data from 27,000 patients resected for cure yield a recurrence rate ranging between from 5.6 to 12.8 % of the cases [54][55][56][57][58][59][60][61][62][63] (Table 2).…”

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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Surgical resection of recurrent colonic cancer

Abstract: This study described a classification system, management algorithm and prognostic factors for recurrent colonic cancer. The distribution of disease influenced survival. Long-term survival was achieved, including a subset of patients with drop metastases and/or previous metastasectomy.

Cited by 27 publications

References 22 publications

Surgical Treatment of Recurrent Colorectal Cancer: Short and Long Term Outcomes

Surgical Treatment of Recurrent Colorectal Cancer: Short and Long Term Outcomes

Curative Intent Treatment for Colorectal Cancer with Isolated Brain Metastases: A Case Report

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

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