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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...

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Autores principales: Yun, Jung-A, Huh, Jung Wook, Kim, Hee Cheol, Park, Yoon Ah, Cho, Yong Beom, Yun, Seong Hyeon, Lee, Woo Yong, Chun, Ho-Kyung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
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.
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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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