Theodor Junginger1, Ursula Goenner1, Tong T Trinh2, Achim Heintz3, André Lollert4, Maria Blettner5, Daniel Wollschlaeger6. 1. Department of General and Abdominal Surgery at the University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany. 2. Department of Heart, Chest and Vascular Surgery at the University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany. 3. Department of General, Visceral and Vascular Surgery at the Catholic Hospital Mainz, Mainz, Germany. 4. Department of Diagnostic and Interventional Radiology at the University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany. 5. Institute of Medical Biostatistics, Epidemiology and Informatics at the University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany. 6. Institute of Medical Biostatistics, Epidemiology and Informatics at the University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany Wollschlaeger@uni-mainz.de.
Abstract
BACKGROUND/AIM: The relationships between local recurrence (LR), the development of distant metastases (DM) and prognosis in patients with rectal cancer remain unclear. PATIENTS AND METHODS: In 606 patients who underwent curative resection, the role of LR was assessed retrospectively by time-dependent multivariate Cox models with inverse probability of treatment weighting taking into account competing risks. RESULTS: Patients with LR had more DM than patients without LR (49/79, 62% vs. 86/524, 16.4%; p<0.001); 37% of LR-associated DM developed before or at LR, 63% after diagnosis of LR. Fifty-five percent of patients without DM at diagnosis of LR later developed DM. In these patients, the incidence of DM significantly exceeded the incidence in patients without LR. DM risk was most strongly associated with preceding LR and stage UICC III and II. CONCLUSION: There is a causal link between LR and DM in patients with rectal cancer. Copyright
BACKGROUND/AIM: The relationships between local recurrence (LR), the development of distant metastases (DM) and prognosis in patients with rectal cancer remain unclear. PATIENTS AND METHODS: In 606 patients who underwent curative resection, the role of LR was assessed retrospectively by time-dependent multivariate Cox models with inverse probability of treatment weighting taking into account competing risks. RESULTS:Patients with LR had more DM than patients without LR (49/79, 62% vs. 86/524, 16.4%; p<0.001); 37% of LR-associated DM developed before or at LR, 63% after diagnosis of LR. Fifty-five percent of patients without DM at diagnosis of LR later developed DM. In these patients, the incidence of DM significantly exceeded the incidence in patients without LR. DM risk was most strongly associated with preceding LR and stage UICC III and II. CONCLUSION: There is a causal link between LR and DM in patients with rectal cancer. Copyright
Authors: S E van Oostendorp; L J H Smits; Y Vroom; R Detering; M W Heymans; L M G Moons; P J Tanis; E J R de Graaf; C Cunningham; Q Denost; M Kusters; J B Tuynman Journal: Br J Surg Date: 2020-09-16 Impact factor: 6.939