BACKGROUND: The purpose of this study is to investigate prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer and determine whether recurrence patterns influence curative resection of recurrent tumor. MATERIALS AND METHODS: We examined 62 patients with isolated local recurrence following total mesorectal excision (TME) of the primary rectal cancer. Recurrence patterns were classified as central, anterior, posterior, lateral, and perineal with respect to the intra-pelvic tumor location. Prognostic factors affecting oncologic outcomes were analyzed, and the rate of curative resection was analyzed according to recurrence patterns. RESULTS: The mean follow-up period was 49.0 +/- 29.0 months, and the mean time to recurrence after TME was 27.9 +/- 23.3 months. Twenty-three patients underwent curative resection, and the remaining 39 patients received palliative treatment. Patients with a central recurrence had the highest rate of curative resection (p = 0.006). The overall 5-year survival rate was 13.9% and significantly higher in those treated with curative resection (35.1%; p = 0.0002). Multivariate analysis demonstrated that disease-free survival less than 1 year and curative resection of local recurrence were independent prognostic factors influencing 5-year survival. CONCLUSION: Patients with central recurrences have a high probability of curative resection. Disease-free survival less than 1 year and curative resection of local recurrence were independent prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer.
BACKGROUND: The purpose of this study is to investigate prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer and determine whether recurrence patterns influence curative resection of recurrent tumor. MATERIALS AND METHODS: We examined 62 patients with isolated local recurrence following total mesorectal excision (TME) of the primary rectal cancer. Recurrence patterns were classified as central, anterior, posterior, lateral, and perineal with respect to the intra-pelvic tumor location. Prognostic factors affecting oncologic outcomes were analyzed, and the rate of curative resection was analyzed according to recurrence patterns. RESULTS: The mean follow-up period was 49.0 +/- 29.0 months, and the mean time to recurrence after TME was 27.9 +/- 23.3 months. Twenty-three patients underwent curative resection, and the remaining 39 patients received palliative treatment. Patients with a central recurrence had the highest rate of curative resection (p = 0.006). The overall 5-year survival rate was 13.9% and significantly higher in those treated with curative resection (35.1%; p = 0.0002). Multivariate analysis demonstrated that disease-free survival less than 1 year and curative resection of local recurrence were independent prognostic factors influencing 5-year survival. CONCLUSION:Patients with central recurrences have a high probability of curative resection. Disease-free survival less than 1 year and curative resection of local recurrence were independent prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer.
Authors: Margo Shoup; Jose G Guillem; Kaled M Alektiar; Kathy Liau; Philip B Paty; Alfred M Cohen; W Douglas Wong; Bruce D Minsky Journal: Dis Colon Rectum Date: 2002-05 Impact factor: 4.585
Authors: K Suzuki; L L Gunderson; R M Devine; A L Weaver; R R Dozois; D M Ilstrup; J A Martenson; M J O'Connell Journal: Cancer Date: 1995-02-15 Impact factor: 6.860
Authors: Johannes Klose; Ignazio Tarantino; Thomas Schmidt; Thomas Bruckner; Yakup Kulu; Tobias Wagner; Martin Schneider; Markus W Büchler; Alexis Ulrich Journal: J Gastrointest Surg Date: 2015-03-31 Impact factor: 3.452
Authors: Johannes Fritzmann; Pietro Contin; Christoph Reissfelder; Markus W Büchler; Jürgen Weitz; Nuh N Rahbari; Alexis B Ulrich Journal: Langenbecks Arch Surg Date: 2018-03-09 Impact factor: 3.445
Authors: I Shaikh; W Aston; G Hellawell; D Ross; S Littler; D Burling; M Marshall; J M A Northover; A Antoniou; J T Jenkins Journal: Tech Coloproctol Date: 2014-11-08 Impact factor: 3.781
Authors: Y N You; J M Skibber; C-Y Hu; C H Crane; P Das; E S Kopetz; C Eng; B W Feig; M A Rodriguez-Bigas; G J Chang Journal: Br J Surg Date: 2016-03-02 Impact factor: 6.939