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Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study

Background and Objectives: Despite advances in treatment, local recurrence remains a great concern in patients with rectal cancer. The aim of this study was to investigate the incidence and risk factors of local recurrence of rectal cancer in our single center over a 7-year-period. Materials and Met...

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Autores principales: Jankowski, Michał, Las-Jankowska, Manuela, Rutkowski, Andrzej, Bała, Dariusz, Wiśniewski, Dorian, Tkaczyński, Karol, Kowalski, Witold, Głowacka-Mrotek, Iwona, Zegarski, Wojciech
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003449/
https://www.ncbi.nlm.nih.gov/pubmed/33808603
http://dx.doi.org/10.3390/medicina57030286
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author Jankowski, Michał
Las-Jankowska, Manuela
Rutkowski, Andrzej
Bała, Dariusz
Wiśniewski, Dorian
Tkaczyński, Karol
Kowalski, Witold
Głowacka-Mrotek, Iwona
Zegarski, Wojciech
author_facet Jankowski, Michał
Las-Jankowska, Manuela
Rutkowski, Andrzej
Bała, Dariusz
Wiśniewski, Dorian
Tkaczyński, Karol
Kowalski, Witold
Głowacka-Mrotek, Iwona
Zegarski, Wojciech
author_sort Jankowski, Michał
collection PubMed
description Background and Objectives: Despite advances in treatment, local recurrence remains a great concern in patients with rectal cancer. The aim of this study was to investigate the incidence and risk factors of local recurrence of rectal cancer in our single center over a 7-year-period. Materials and Methods: Patients with stage I-III rectal cancer were treated with curative intent. The necessity for radiotherapy and chemotherapy was determined before surgery and/or postoperative histopathological results. Results: Of 365 rectal cancer patients, 76 (20.8%) developed recurrent disease. In total, 27 (7.4%) patients presented with a local tumor recurrence (isolated in 40.7% of cases). Radiotherapy was performed in 296 (81.1%) patients. The most often used schema was 5 × 5 Gy followed by immediate surgery (n = 214, 58.6%). Local recurrence occurred less frequently in patients treated with 5 × 5 Gy radiotherapy followed by surgery (n = 9, 4%). Surgical procedures of relapses were performed in 12 patients, six of whom were operated with radical intent. Only two (7.4%) patients lived more than 5 years after local recurrence treatment. The incidence of local recurrence was associated with primary tumor distal location and worse prognosis. The median overall survival of patients after local recurrence treatment was 19 months. Conclusions: Individualized rectal cancer patient selection and systematic treatment algorithms should be used clinical practice to minimize likelihood of relapse. 5 × 5 Gy radiotherapy followed by immediate surgery allows good local control in resectable cT2N+/cT3N0 patients. Radical resection of isolated local recurrence offers the best chances of cure.
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spelling pubmed-80034492021-03-28 Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study Jankowski, Michał Las-Jankowska, Manuela Rutkowski, Andrzej Bała, Dariusz Wiśniewski, Dorian Tkaczyński, Karol Kowalski, Witold Głowacka-Mrotek, Iwona Zegarski, Wojciech Medicina (Kaunas) Article Background and Objectives: Despite advances in treatment, local recurrence remains a great concern in patients with rectal cancer. The aim of this study was to investigate the incidence and risk factors of local recurrence of rectal cancer in our single center over a 7-year-period. Materials and Methods: Patients with stage I-III rectal cancer were treated with curative intent. The necessity for radiotherapy and chemotherapy was determined before surgery and/or postoperative histopathological results. Results: Of 365 rectal cancer patients, 76 (20.8%) developed recurrent disease. In total, 27 (7.4%) patients presented with a local tumor recurrence (isolated in 40.7% of cases). Radiotherapy was performed in 296 (81.1%) patients. The most often used schema was 5 × 5 Gy followed by immediate surgery (n = 214, 58.6%). Local recurrence occurred less frequently in patients treated with 5 × 5 Gy radiotherapy followed by surgery (n = 9, 4%). Surgical procedures of relapses were performed in 12 patients, six of whom were operated with radical intent. Only two (7.4%) patients lived more than 5 years after local recurrence treatment. The incidence of local recurrence was associated with primary tumor distal location and worse prognosis. The median overall survival of patients after local recurrence treatment was 19 months. Conclusions: Individualized rectal cancer patient selection and systematic treatment algorithms should be used clinical practice to minimize likelihood of relapse. 5 × 5 Gy radiotherapy followed by immediate surgery allows good local control in resectable cT2N+/cT3N0 patients. Radical resection of isolated local recurrence offers the best chances of cure. MDPI 2021-03-19 /pmc/articles/PMC8003449/ /pubmed/33808603 http://dx.doi.org/10.3390/medicina57030286 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Jankowski, Michał
Las-Jankowska, Manuela
Rutkowski, Andrzej
Bała, Dariusz
Wiśniewski, Dorian
Tkaczyński, Karol
Kowalski, Witold
Głowacka-Mrotek, Iwona
Zegarski, Wojciech
Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study
title Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study
title_full Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study
title_fullStr Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study
title_full_unstemmed Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study
title_short Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study
title_sort clinical reality and treatment for local recurrence of rectal cancer: a single-center retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003449/
https://www.ncbi.nlm.nih.gov/pubmed/33808603
http://dx.doi.org/10.3390/medicina57030286
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