BACKGROUND: The optimal combination of available therapies for patients with resectable synchronous liver metastases from rectal cancer (SLMRC) is unknown, and the pattern of recurrence after resection has been poorly investigated. In this study, the authors examined recurrence patterns and survival after resection of SLMRC. METHODS: Consecutive patients with SLMRC (disease-free interval, ≤12 months) who underwent complete resection of the rectal primary and liver metastases between 1990 and 2008 were identified from a prospective database. Demographics, tumor-related variables, and treatment-related variables were correlated with recurrence patterns. Competing risk analysis was used to determine the risk of pelvic and extrapelvic recurrence. RESULTS: In total, 185 patients underwent complete resection of rectal primary and liver metastases. One hundred eighty patients (97%) received chemotherapy during their treatment course, and 91 patients (49%) received pelvic radiation therapy either before (N = 65; 71.4%), or after (N = 26; 28.6%) rectal resection. The 5-year disease-specific survival rate was 51% for the entire cohort with a median follow-up of 44 months for survivors. One hundred thirty patients (70%) developed a recurrence: Eighteen patients (10%) had recurrences in the pelvis in combination with other sites, and 7 of these (4%) had an isolated pelvic recurrence. Recurrence pattern did not correlate with survival. Competing risk analysis demonstrated that the likelihood of a pelvic recurrence was significantly lower than that of an extrapelvic recurrence (P < .001). CONCLUSIONS: Of the patients with SLMRC who developed recurrent disease, systemic sites were overwhelmingly more common than pelvic recurrences. The current results indicated that the selective exclusion of radiotherapy may be considered in patients who are diagnosed with simultaneous disease.
BACKGROUND: The optimal combination of available therapies for patients with resectable synchronous liver metastases from rectal cancer (SLMRC) is unknown, and the pattern of recurrence after resection has been poorly investigated. In this study, the authors examined recurrence patterns and survival after resection of SLMRC. METHODS: Consecutive patients with SLMRC (disease-free interval, ≤12 months) who underwent complete resection of the rectal primary and liver metastases between 1990 and 2008 were identified from a prospective database. Demographics, tumor-related variables, and treatment-related variables were correlated with recurrence patterns. Competing risk analysis was used to determine the risk of pelvic and extrapelvic recurrence. RESULTS: In total, 185 patients underwent complete resection of rectal primary and liver metastases. One hundred eighty patients (97%) received chemotherapy during their treatment course, and 91 patients (49%) received pelvic radiation therapy either before (N = 65; 71.4%), or after (N = 26; 28.6%) rectal resection. The 5-year disease-specific survival rate was 51% for the entire cohort with a median follow-up of 44 months for survivors. One hundred thirty patients (70%) developed a recurrence: Eighteen patients (10%) had recurrences in the pelvis in combination with other sites, and 7 of these (4%) had an isolated pelvic recurrence. Recurrence pattern did not correlate with survival. Competing risk analysis demonstrated that the likelihood of a pelvic recurrence was significantly lower than that of an extrapelvic recurrence (P < .001). CONCLUSIONS: Of the patients with SLMRC who developed recurrent disease, systemic sites were overwhelmingly more common than pelvic recurrences. The current results indicated that the selective exclusion of radiotherapy may be considered in patients who are diagnosed with simultaneous disease.
Authors: A J Hyde; R Nassabein; A AlShareef; D Armstrong; S Babak; S Berry; D Bossé; E Chen; B Colwell; C Essery; R Goel; R Goodwin; S Gray; N Hammad; A Jeyakuymar; D Jonker; P Karanicolas; N Lamond; R Letourneau; J Michael; N Patil; E Powell; R Ramjeesingh; W Saliba; R Singh; S Snow; T Stuckless; S Tadros; M Tehfé; M Thana; M Thirlwell; M Vickers; K Virik; S Welch; T Asmis Journal: Curr Oncol Date: 2019-10-01 Impact factor: 3.677
Authors: Eddie K Abdalla; Todd W Bauer; Yun S Chun; Michael D'Angelica; David A Kooby; William R Jarnagin Journal: HPB (Oxford) Date: 2013-02 Impact factor: 3.647
Authors: Bindu V Manyam; Ismail H Mallick; May M Abdel-Wahab; Chandana A Reddy; Feza H Remzi; Matthew F Kalady; Ian Lavery; Shlomo A Koyfman Journal: J Gastrointest Surg Date: 2015-05-27 Impact factor: 3.452
Authors: Renato Micelli Lupinacci; François Paye; Fabricio Ferreira Coelho; Jaime Arthur Pirolla Kruger; Paulo Herman Journal: Updates Surg Date: 2014-08-29
Authors: Croix C Fossum; Jasim Y Alabbad; Lindsay B Romak; Christopher L Hallemeier; Michael G Haddock; Marianne Huebner; Eric J Dozois; David W Larson Journal: J Gastrointest Oncol Date: 2017-08
Authors: Marlen Haderlein; Sebastian Lettmaier; Melanie Langheinrich; Axel Schmid; Sabine Semrau; Markus Hecht; Michael Beck; Daniela Schmidt; Robert Grützmann; Rainer Fietkau; Axel Denz Journal: Int J Colorectal Dis Date: 2018-07-02 Impact factor: 2.571