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Local recurrence after curative resection for rectal carcinoma: The role of surgical resection
Local recurrence of rectal cancer is difficult to treat, may cause severe and disabling symptoms, and usually has a fatal outcome. The aim of this study was to document the clinical nature of locally recurrent rectal cancer and to determine the effect of surgical resection on long-term survival. A r...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058796/ https://www.ncbi.nlm.nih.gov/pubmed/27399067 http://dx.doi.org/10.1097/MD.0000000000003942 |
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author | Yun, Jung-A Huh, Jung Wook Kim, Hee Cheol Park, Yoon Ah Cho, Yong Beom Yun, Seong Hyeon Lee, Woo Yong Chun, Ho-Kyung |
author_facet | Yun, Jung-A Huh, Jung Wook Kim, Hee Cheol Park, Yoon Ah Cho, Yong Beom Yun, Seong Hyeon Lee, Woo Yong Chun, Ho-Kyung |
author_sort | Yun, Jung-A |
collection | PubMed |
description | Local recurrence of rectal cancer is difficult to treat, may cause severe and disabling symptoms, and usually has a fatal outcome. The aim of this study was to document the clinical nature of locally recurrent rectal cancer and to determine the effect of surgical resection on long-term survival. A retrospective review was conducted of the prospectively collected medical records of 2485 patients with primary rectal adenocarcinoma who underwent radical resection between September 1994 and December 2008. In total, 147 (5.9%) patients exhibited local recurrence. The most common type of local recurrence was lateral recurrence, whereas anastomotic recurrence was the most common type in patients without preoperative concurrent chemoradiotherapy (CCRT). Tumor location with respect to the anal verge significantly affected the local recurrence rate (P < 0.001), whereas preoperative CCRT did not affect the local recurrence rate (P = 0.433). Predictive factors for surgical resection of recurrent rectal cancer included less advanced tumor stage (P = 0.017, RR = 3.840, 95% CI = 1.271–11.597), axial recurrence (P < 0.001, RR = 5.772, 95% CI = 2.281–14.609), and isolated local recurrence (P = 0.006, RR = 8.679, 95% CI = 1.846–40.815). Overall survival after diagnosis of local recurrence was negatively influenced by advanced pathologic tumor stage (P = 0.040, RR = 1.867, 95% CI = 1.028–3.389), positive CRM (P = 0.001, RR = 12.939, 95% CI = 2.906–57.604), combined distant metastases (P = 0.001, RR = 2.086, 95% CI = 1.352–3.218), and nonsurgical resection of recurrent tumor (P < 0.001, RR = 4.865, 95% CI = 2.586–9.153). In conclusion, the clinical outcomes of local recurrence after curative resection of rectal cancer are diverse. Surgical resection of locally recurrent rectal cancer should be considered as an initial treatment, especially in patients with less advanced tumors and axial recurrence. |
format | Online Article Text |
id | pubmed-5058796 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-50587962016-11-18 Local recurrence after curative resection for rectal carcinoma: The role of surgical resection Yun, Jung-A Huh, Jung Wook Kim, Hee Cheol Park, Yoon Ah Cho, Yong Beom Yun, Seong Hyeon Lee, Woo Yong Chun, Ho-Kyung Medicine (Baltimore) 7100 Local recurrence of rectal cancer is difficult to treat, may cause severe and disabling symptoms, and usually has a fatal outcome. The aim of this study was to document the clinical nature of locally recurrent rectal cancer and to determine the effect of surgical resection on long-term survival. A retrospective review was conducted of the prospectively collected medical records of 2485 patients with primary rectal adenocarcinoma who underwent radical resection between September 1994 and December 2008. In total, 147 (5.9%) patients exhibited local recurrence. The most common type of local recurrence was lateral recurrence, whereas anastomotic recurrence was the most common type in patients without preoperative concurrent chemoradiotherapy (CCRT). Tumor location with respect to the anal verge significantly affected the local recurrence rate (P < 0.001), whereas preoperative CCRT did not affect the local recurrence rate (P = 0.433). Predictive factors for surgical resection of recurrent rectal cancer included less advanced tumor stage (P = 0.017, RR = 3.840, 95% CI = 1.271–11.597), axial recurrence (P < 0.001, RR = 5.772, 95% CI = 2.281–14.609), and isolated local recurrence (P = 0.006, RR = 8.679, 95% CI = 1.846–40.815). Overall survival after diagnosis of local recurrence was negatively influenced by advanced pathologic tumor stage (P = 0.040, RR = 1.867, 95% CI = 1.028–3.389), positive CRM (P = 0.001, RR = 12.939, 95% CI = 2.906–57.604), combined distant metastases (P = 0.001, RR = 2.086, 95% CI = 1.352–3.218), and nonsurgical resection of recurrent tumor (P < 0.001, RR = 4.865, 95% CI = 2.586–9.153). In conclusion, the clinical outcomes of local recurrence after curative resection of rectal cancer are diverse. Surgical resection of locally recurrent rectal cancer should be considered as an initial treatment, especially in patients with less advanced tumors and axial recurrence. Wolters Kluwer Health 2016-07-08 /pmc/articles/PMC5058796/ /pubmed/27399067 http://dx.doi.org/10.1097/MD.0000000000003942 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0 |
spellingShingle | 7100 Yun, Jung-A Huh, Jung Wook Kim, Hee Cheol Park, Yoon Ah Cho, Yong Beom Yun, Seong Hyeon Lee, Woo Yong Chun, Ho-Kyung Local recurrence after curative resection for rectal carcinoma: The role of surgical resection |
title | Local recurrence after curative resection for rectal carcinoma: The role of surgical resection |
title_full | Local recurrence after curative resection for rectal carcinoma: The role of surgical resection |
title_fullStr | Local recurrence after curative resection for rectal carcinoma: The role of surgical resection |
title_full_unstemmed | Local recurrence after curative resection for rectal carcinoma: The role of surgical resection |
title_short | Local recurrence after curative resection for rectal carcinoma: The role of surgical resection |
title_sort | local recurrence after curative resection for rectal carcinoma: the role of surgical resection |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058796/ https://www.ncbi.nlm.nih.gov/pubmed/27399067 http://dx.doi.org/10.1097/MD.0000000000003942 |
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