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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 12/2021

01-12-2021 | Rectal Cancer | Original Article

Type of recurrence is associated with disease-free survival after salvage surgery for locally recurrent rectal cancer

Authors: Rosa M. Jimenez-Rodriguez, Jonathan B. Yuval, Charles-Etienne Gabriel Sauve, Isaac Wasserman, Piyush Aggarwal, Paul B. Romesser, Christopher H. Crane, Rona Yaeger, Andrea Cercek, Jose G. Guillem, Martin R. Weiser, Iris H. Wei, Maria Widmar, Garrett M. Nash, Emmanouil P. Pappou, Julio Garcia-Aguilar, Marc J. Gollub, Philip B. Paty, J. Joshua Smith

Published in: International Journal of Colorectal Disease | Issue 12/2021

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Abstract

Purpose

To compare the characteristics and outcomes of rectal cancer patients with local recurrence at a perianastomotic site (PA), a surgical field (SF) site, or in lateral lymph nodes (LLN).

Methods

A total of 114 consecutive patients who underwent surgery for recurrent, non-metastatic rectal cancer at a single comprehensive cancer center between 1997 and 2012 were grouped on the basis of radiographic assessment of type of recurrence: PA, 76 (67%) patients; SF, 25 (22%) patients; LLN, 13 (11%) patients. Demographic, clinical, and pathological features were compared between the three groups, as were disease-free survival (DFS) and overall survival (OS).

Results

Recurrence type was associated with positive circumferential margin in the primary resection (PA, 4 [6%]; SF, 4 [19%]; LLN, 3 [25%]; P = 0.027), prior neoadjuvant therapy for the primary tumor (PA, 57 [75%]; SF, 18 [72%]; LLN, 4 [31%]; P = 0.007), and location of the primary tumor in the upper rectum (PA, 33 [45%]; SF, 5 [23%]; LLN, 1 [8%]; P < 0.001). Patients with PA had longer median DFS (PA, 5.1 years; SF, 1.5 years; LLN, 1.2 years; P = 0.036). There was a non-significant trend toward longer OS and higher rates of R0 resection for PA.

Conclusion

Type of recurrence after salvage surgery for locally recurrent rectal cancer is associated with longer DFS in patients with PA recurrence.
Literature
1.
Heriot AG, Tekkis PP, Darzi A, Mackay J (2006) Surgery for local recurrence of rectal cancer. Colorectal Dis 8:733–747CrossRef
2.
Hagemans JAW, van Rees JM, Alberda WJ, Rothbarth J, Nuyttens J, van Meerten E et al (2020) Locally recurrent rectal cancer; long-term outcome of curative surgical and non-surgical treatment of 447 consecutive patients in a tertiary referral centre. Eur J Surg Oncol 46:448–454CrossRef
3.
MacFarlane JK, Ryall RD, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet (London, England) 341:457–460CrossRef
4.
Bosset JF, Calais G, Mineur L, Maingon P, Radosevic-Jelic L, Daban A et al (2005) Enhanced tumorocidal effect of chemotherapy with preoperative radiotherapy for rectal cancer: preliminary results–EORTC 22921. J Clin Oncol 23:5620–5627CrossRef
5.
Cedermark B, Dahlberg M, Glimelius B, Pahlman L, Rutqvist LE, Wilking N (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987CrossRef
6.
Syk E, Torkzad MR, Blomqvist L, Ljungqvist O, Glimelius B (2006) Radiological findings do not support lateral residual tumour as a major cause of local recurrence of rectal cancer. Br J Surg 93:113–119CrossRef
7.
Pilipshen SJ, Heilweil M, Quan SH, Sternberg SS, Enker WE (1984) Patterns of pelvic recurrence following definitive resections of rectal cancer. Cancer 53:1354–1362CrossRef
8.
Enriquez-Navascues JM, Borda N, Lizerazu A, Placer C, Elosegui JL, Ciria JP et al (2011) Patterns of local recurrence in rectal cancer after a multidisciplinary approach. World J Gastroenterol 17:1674–1684CrossRef
9.
Bernstein TE, Endreseth BH, Romundstad P, Wibe A (2009) Circumferential resection margin as a prognostic factor in rectal cancer. Br J Surg 96:1348–1357CrossRef
10.
Kusters M, Wallner C, Lange MM, DeRuiter MC, van de Velde CJ, Moriya Y et al (2010) Origin of presacral local recurrence after rectal cancer treatment. Br J Surg 97:1582–1587CrossRef
11.
Wibe A, Syse A, Andersen E, Tretli S, Myrvold HE, Soreide O, Norwegian Rectal Cancer Group (2004) Oncological outcomes after total mesorectal excision for cure for cancer of the lower rectum: anterior vs. abdominoperineal resection. Dis Colon Rectum 47: 48–58.
12.
Suzuki K, Dozois RR, Devine RM, Nelson H, Weaver AL, Gunderson LL et al (1996) Curative reoperations for locally recurrent rectal cancer. Dis Colon Rectum 39:730–736CrossRef
13.
Wanebo HJ, Antoniuk P, Koness RJ, Levy A, Vezeridis M, Cohen SI et al (1999) Pelvic resection of recurrent rectal cancer: technical considerations and outcomes. Dis Colon Rectum 42:1438–1448CrossRef
14.
Yamada K, Ishizawa T, Niwa K, Chuman Y, Akiba S, Aikou T (2001) Patterns of pelvic invasion are prognostic in the treatment of locally recurrent rectal cancer. Br J Surg 88:988–993CrossRef
15.
Belli F, Sorrentino L, Gallino G, Gronchi A, Scaramuzza D, Valvo F et al (2020) A proposal of an updated classification for pelvic relapses of rectal cancer to guide surgical decision-making. J Surg Oncol 122:350–359CrossRef
16.
Sorrentino L, Belli F, Valvo F, Villa S, Guaglio M, Scaramuzza D et al (2020) Neoadjuvant (re)chemoradiation for locally recurrent rectal cancer: impact of anatomical site of pelvic recurrence on long-term results. Surg Oncol 35:89–96CrossRef
17.
Alberda WJ, Verhoef C, Schipper ME, Nuyttens JJ, Rothbarth J, de Wilt JH et al (2015) The importance of a minimal tumor-free resection margin in locally recurrent rectal cancer. Dis Colon Rectum 58:677–685CrossRef
18.
Rahbari NN, Ulrich AB, Bruckner T, Munter M, Nickles A, Contin P et al (2011) Surgery for locally recurrent rectal cancer in the era of total mesorectal excision: is there still a chance for cure? Ann Surg 253:522–533CrossRef
19.
Williamson JS, Quyn AJ, Sagar PM (2020) Rectal cancer lateral pelvic sidewall lymph nodes: a review of controversies and management. Br J Surg 107:1562–1569CrossRef
20.
Moore HG, Shoup M, Riedel E, Minsky BD, Alektiar KM, Ercolani M et al (2004) Colorectal cancer pelvic recurrences: determinants of resectability. Dis Colon Rectum 47:1599–1606CrossRef
21.
Wiig JN, Giercksky KE, Tveit KM (2014) Intraoperative radiotherapy for locally advanced or locally recurrent rectal cancer: does it work at all? Acta Oncol 53:865–876CrossRef
22.
Bosman SJ, Holman FA, Nieuwenhuijzen GA, Martijn H, Creemers GJ, Rutten HJ (2014) Feasibility of reirradiation in the treatment of locally recurrent rectal cancer. Br J Surg 101:1280–1289CrossRef
23.
Holman FA, Bosman SJ, Haddock MG, Gunderson LL, Kusters M, Nieuwenhuijzen GA (2017) Results of a pooled analysis of IOERT containing multimodality treatment for locally recurrent rectal cancer: results of 565 patients of two major treatment centres. Eur J Surg Oncol 43:107–117CrossRef
24.
Brady JT, Xu Z, Scarberry KB, Saad A, Fleming FJ, Remzi FH et al (2018) Evaluating the current status of rectal cancer care in the US: where we stand at the Start of the Commission on Cancer’s National Accreditation Program for Rectal Cancer. J Am Coll Surg 226:881–890CrossRef
25.
Stringfield SB, Fleshman JW (2021) Specialization improves outcomes in rectal cancer surgery. Surg Oncol 37: 101568.
Metadata
Title
Type of recurrence is associated with disease-free survival after salvage surgery for locally recurrent rectal cancer
Authors
Rosa M. Jimenez-Rodriguez
Jonathan B. Yuval
Charles-Etienne Gabriel Sauve
Isaac Wasserman
Piyush Aggarwal
Paul B. Romesser
Christopher H. Crane
Rona Yaeger
Andrea Cercek
Jose G. Guillem
Martin R. Weiser
Iris H. Wei
Maria Widmar
Garrett M. Nash
Emmanouil P. Pappou
Julio Garcia-Aguilar
Marc J. Gollub
Philip B. Paty
J. Joshua Smith
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 12/2021
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-021-03998-4

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