Impact of Anatomic Location on Locally Recurrent Rectal Cancer: Superior Outcome for Intraluminal Tumour Recurrence

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2015 Mar 31

PMID 25822061

Citations 2

Authors

Johannes Klose

Ignazio Tarantino

Thomas Schmidt

Thomas Bruckner

Yakup Kulu

Tobias Wagner

Martin Schneider

Markus W Buchler

Alexis Ulrich

Affiliations

Soon will be listed here.

Abstract

Background: Local recurrence of rectal cancer after curative surgery predicts patients' prognosis. The correlation between the exact anatomic location of tumour recurrence and patients' survival is still under debate. Thus, this study aimed to investigate the impact of the exact location of recurrent rectal cancer on post-operative morbidity and survival.

Methods: This is a retrospective study including 90 patients with locally recurrent rectal cancer. The location of tumour recurrence was classified into intraluminal and extraluminal recurrence. Univariate and multivariable Cox regression analyses were used to determine the impact on post-operative morbidity and survival.

Results: Patients' survival with intraluminal recurrence was significantly longer compared to patients with extraluminal recurrence (p = 0.027). Curative resection was associated with prolonged survival in univariate and multivariable analyses (p = 0.0001) and was more often achieved in patients with intraluminal recurrence (p = 0.024). Survival of curative resected patients with intraluminal recurrence was significantly longer compared to curatively resected patients with extraluminal recurrence (p = 0.0001). The rate of post-operative morbidity between intraluminal and extraluminal recurrence was not statistically different (p = 0.59).

Conclusion: Based on the present investigation, intraluminal recurrence is associated with superior outcome. Post-operative morbidity did not differ significantly between both groups.

Citing Articles

Post recurrence survival in early versus late period and its prognostic factors in rectal cancer patients.

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Outcomes and prognostic factors of multimodality treatment for locally recurrent rectal cancer with curative intent.

Bird T, Ngan S, Chu J, Kroon R, Lynch A, Heriot A Int J Colorectal Dis. 2018; 33(4):393-401.

PMID: 29468354 DOI: 10.1007/s00384-018-2985-y.

References

Rahbari N, Ulrich A, Bruckner T, Munter M, Nickles A, Contin P . Surgery for locally recurrent rectal cancer in the era of total mesorectal excision: is there still a chance for cure?. Ann Surg. 2011; 253(3):522-33. DOI: 10.1097/SLA.0b013e3182096d4f. View

Nielsen M, Rasmussen P, Pedersen B, Hagemann-Madsen R, Lindegaard J, Laurberg S . Early and Late Outcomes of Surgery for Locally Recurrent Rectal Cancer: A Prospective 10-Year Study in the Total Mesorectal Excision Era. Ann Surg Oncol. 2015; 22(8):2677-84. DOI: 10.1245/s10434-014-4317-y. View

Simunovic M, Sexton R, Rempel E, Moran B, Heald R . Optimal preoperative assessment and surgery for rectal cancer may greatly limit the need for radiotherapy. Br J Surg. 2003; 90(8):999-1003. DOI: 10.1002/bjs.4210. View

de Chaisemartin C, Penna C, Goere D, Benoist S, Beauchet A, Julie C . Presentation and prognosis of local recurrence after total mesorectal excision. Colorectal Dis. 2008; 11(1):60-6. DOI: 10.1111/j.1463-1318.2008.01537.x. View

McDermott F, Hughes E, Pihl E, Johnson W, Price A . Local recurrence after potentially curative resection for rectal cancer in a series of 1008 patients. Br J Surg. 1985; 72(1):34-7. DOI: 10.1002/bjs.1800720115. View

Cai Y, Li Z, Gu X, Fang Y, Xiang J, Chen Z . Prognostic factors associated with locally recurrent rectal cancer following primary surgery (Review). Oncol Lett. 2013; 7(1):10-16. PMC: 3861572. DOI: 10.3892/ol.2013.1640. View

Asoglu O, Karanlik H, Muslumanoglu M, Igci A, Emek E, Ozmen V . Prognostic and predictive factors after surgical treatment for locally recurrent rectal cancer: a single institute experience. Eur J Surg Oncol. 2007; 33(10):1199-206. DOI: 10.1016/j.ejso.2007.02.026. View

Nagtegaal I, van de Velde C, Marijnen C, van Krieken J, Quirke P . Low rectal cancer: a call for a change of approach in abdominoperineal resection. J Clin Oncol. 2005; 23(36):9257-64. DOI: 10.1200/JCO.2005.02.9231. View

Marr R, Birbeck K, Garvican J, Macklin C, Tiffin N, Parsons W . The modern abdominoperineal excision: the next challenge after total mesorectal excision. Ann Surg. 2005; 242(1):74-82. PMC: 1357707. DOI: 10.1097/01.sla.0000167926.60908.15. View

10.

Camma C, Giunta M, Fiorica F, Pagliaro L, Craxi A, Cottone M . Preoperative radiotherapy for resectable rectal cancer: A meta-analysis. JAMA. 2000; 284(8):1008-15. DOI: 10.1001/jama.284.8.1008. View

11.

Bruheim K, Tveit K, Skovlund E, Balteskard L, Carlsen E, Fossa S . Sexual function in females after radiotherapy for rectal cancer. Acta Oncol. 2010; 49(6):826-32. DOI: 10.3109/0284186X.2010.486411. View

12.

Hamano T, Homma Y, Otsuki Y, Shimizu S, Kobayashi H, Kobayashi Y . Inguinal lymph node metastases are recognized with high frequency in rectal adenocarcinoma invading the dentate line. The histological features at the invasive front may predict inguinal lymph node metastasis. Colorectal Dis. 2009; 12(10 Online):e200-5. DOI: 10.1111/j.1463-1318.2009.02134.x. View

13.

Umpleby H, Fermor B, Symes M, Williamson R . Viability of exfoliated colorectal carcinoma cells. Br J Surg. 1984; 71(9):659-63. DOI: 10.1002/bjs.1800710902. View

14.

Taylor F, Quirke P, Heald R, Moran B, Blomqvist L, Swift I . Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study. Ann Surg. 2011; 253(4):711-9. DOI: 10.1097/SLA.0b013e31820b8d52. View

15.

van Gijn W, Marijnen C, Nagtegaal I, Meershoek-Klein Kranenbarg E, Putter H, Wiggers T . Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011; 12(6):575-82. DOI: 10.1016/S1470-2045(11)70097-3. View

16.

van den Brink M, Stiggelbout A, van den Hout W, Kievit J, Kranenbarg E, Marijnen C . Clinical nature and prognosis of locally recurrent rectal cancer after total mesorectal excision with or without preoperative radiotherapy. J Clin Oncol. 2004; 22(19):3958-64. DOI: 10.1200/JCO.2004.01.023. View

17.

Minsky B, Mies C, Recht A, Rich T, Chaffey J . Resectable adenocarcinoma of the rectosigmoid and rectum. I. Patterns of failure and survival. Cancer. 1988; 61(7):1408-16. DOI: 10.1002/1097-0142(19880401)61:7<1408::aid-cncr2820610722>3.0.co;2-a. View

18.

Bruheim K, Guren M, Skovlund E, Hjermstad M, Dahl O, Frykholm G . Late side effects and quality of life after radiotherapy for rectal cancer. Int J Radiat Oncol Biol Phys. 2009; 76(4):1005-11. DOI: 10.1016/j.ijrobp.2009.03.010. View

19.

Schurr P, Lentz E, Block S, Kaifi J, Kleinhans H, Cataldegirmen G . Radical redo surgery for local rectal cancer recurrence improves overall survival: a single center experience. J Gastrointest Surg. 2008; 12(7):1232-8. DOI: 10.1007/s11605-008-0517-8. View

20.

Delpero J, Pol B, Le Treut P, Bardou V, Moutardier V, Hardwigsen J . Surgical resection of locally recurrent colorectal adenocarcinoma. Br J Surg. 1998; 85(3):372-6. DOI: 10.1046/j.1365-2168.1998.00583.x. View