The Outcomes and Patterns of Treatment Failure After Surgery for Locally Recurrent Rectal Cancer

Harris, Chas. K.; Solomon, Michael J.; Heriot, Alexander G.; Sagar, P. M.; Tekkis, Paris; Dixon, Liane; Pascoe, Rebecca; Dobbs, B. R.; Frampton, Chris; Harji, Deena; Kontovounisios, Christos; Austin, Kirk K. S.; Koh, Cherry; Lee, Peter J.; Lynch, A. C.; Warrier, Satish; Frizelle, Frank

doi:10.1097/sla.0000000000001524

Cited by 118 publications

(97 citation statements)

References 21 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite better preoperative and surgical treatment of rectal cancer, the incidence of locally recurrent rectal cancer remains approximately 5–10 per cent. Unlike primary rectal cancer, local recurrence is not confined to a well defined surgical compartment, and multicompartment exenterative procedures are often required to achieve clear resection margins.…”

Section: Introductionmentioning

confidence: 99%

Preliminary results of a cohort study of induction chemotherapy-based treatment for locally recurrent rectal cancer

Zoggel

Bosman

Kusters

et al. 2017

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Preliminary results of a cohort study of induction chemotherapy-based treatment for locally recurrent rectal cancer

Zoggel

Bosman

Kusters

et al. 2017

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Although a macroscopically complete resection with negative margins (R0) is the goal, a macroscopically complete resection with positive margins (R1) or a macroscopically incomplete resection (R2) may be inevitable, with survival consequences. A review of 583 patients with locally recurrent rectal cancer who underwent surgery (approximately 60% R0) reported 5‐year OS rates of 44%, 26%, and 10% for R0, R1, and R2 resections, respectively . Furthermore, anastomotic recurrences, for which re‐resection is more straightforward, are less common in the era of neoadjuvant therapy.…”

Section: Rectal Cancermentioning

confidence: 99%

“…Furthermore, anastomotic recurrences, for which re‐resection is more straightforward, are less common in the era of neoadjuvant therapy. Thus, LRR often requires extensive pelvic exenterations, which have lower rates of success …”

Section: Rectal Cancermentioning

confidence: 99%

“…A review of 583 patients with locally recurrent rectal cancer who underwent surgery (approximately 60% R0) reported 5-year OS rates of 44%, 26%, and 10% for R0, R1, and R2 resections, respectively. 26 Furthermore, anastomotic recurrences, for which re-resection is more straightforward, are less common in the era of neoadjuvant therapy. Thus, LRR often requires extensive pelvic exenterations, which have lower rates of success.…”

Section: Rectal Cancermentioning

confidence: 99%

See 1 more Smart Citation

Local Cancer Recurrence: The Realities, Challenges, and Opportunities for New Therapies

Mahvi

Liu

Grinstaff

et al. 2018

CA A Cancer J Clinicians

240

167

View full text Add to dashboard Cite

Locoregional recurrence negatively impacts both long-term survival and quality of life for a number of malignancies. For appropriate-risk patients with an isolated, resectable local recurrence, surgery represents the only potentially curative therapy. However, oncologic outcomes remain inferior for patients with locally recurrent disease even after macroscopically complete resection. Unfortunately, these operations are often extensive with significant perioperative morbidity and mortality. This review highlights selected malignancies (mesothelioma, sarcoma, lung cancer, breast cancer, rectal cancer, peritoneal surface malignancies) in which surgical resection is a key treatment modality and where local recurrence plays a significant role in overall oncologic outcome with regards to survival and quality of life. For each type of cancer, the current, state-of-the-art treatment strategies and their outcomes are assessed. The need for additional therapeutic options is presented given the limitations of the current standard therapies. New and emerging treatment modalities, including polymer films and nanoparticles, are highlighted as potential future solutions for both prevention and treatment of locally recurrent cancers. Finally, we identify additional clinical and research opportunities, and propose future research strategies based on the varying patterns of local recurrence among the different cancers.

show abstract

“…These together with improvements in perioperative intervention, extended resection or exenterative surgeries are now accepted management options in order to achieve a cure[15]. Results from several of these centres have demonstrated a 5-year survival rate of 35% to 50% after surgery for LRRC[16]. …”

Section: Introductionmentioning

confidence: 99%

Advances in surgical management for locally recurrent rectal cancer: How far have we come?

Lee

Sagar

Sadadcharam

et al. 2017

WJG

View full text Add to dashboard Cite

Locally recurrent rectal cancer (LRRC) is a complex disease with far-reaching implications for the patient. Until recently, research was limited regarding surgical techniques that can increase the ability to perform an en bloc resection with negative margins. This has changed in recent years and therefore outcomes for these patients have improved. Novel radical techniques and adjuncts allow for more radical resections thereby improving the chance of negative resection margins and outcomes. In the past contraindications to surgery included anterior involvement of the pubic bone, sacral invasions above the level of S2/S3 and lateral pelvic wall involvement. However, current data suggests that previously unresectable cases may now be feasible with novel techniques, surgical approaches and reconstructive surgery. The publications to date have only reported small patient pools with the research conducted by highly specialised units. Moreover, the short and long-term oncological outcomes are currently under review. Therefore although surgical options for LRRC have expanded significantly, one should balance the treatment choices available against the morbidity associated with the procedure and select the right patient for it.

show abstract

The Outcomes and Patterns of Treatment Failure After Surgery for Locally Recurrent Rectal Cancer

Cited by 118 publications

References 21 publications

Preliminary results of a cohort study of induction chemotherapy-based treatment for locally recurrent rectal cancer

Preliminary results of a cohort study of induction chemotherapy-based treatment for locally recurrent rectal cancer

Local Cancer Recurrence: The Realities, Challenges, and Opportunities for New Therapies

Advances in surgical management for locally recurrent rectal cancer: How far have we come?

Contact Info

Product

Resources

About