Population‐based study of surgical treatment with and without tumour resection in patients with locally recurrent rectal cancer. BJS 2019; 106: 790-798.
Published: 18th February 2019
Authors: K. Westberg, G. Palmer, F. Hjern, T. Holm, A. Martling
Population‐based studies of treatment of locally recurrent rectal cancer (LRRC) are lacking. The aim was to investigate the surgical treatment of patients with LRRC at a national population‐based level.
All patients undergoing abdominal resection for primary rectal cancer between 1995 and 2002 in Sweden with LRRC as a first event were included. Detailed information about treatment, complications and outcomes was collected from the medical records. The patients were analysed in three groups: patients who had resection of the LRRC, those treated without tumour resection and patients who received best supportive care only.
In all, 426 patients were included in the study. Of these, 149 (35·0 per cent) underwent tumour resection, 193 (45·3 per cent) had treatment without tumour resection and 84 (19·7 per cent) received best supportive care. Abdominoperineal resection was the most frequent surgical procedure, performed in 65 patients (43·6 per cent of those who had tumour resection). Thirteen patients had total pelvic exenteration. In total, 63·8 per cent of those whose tumour was resected had potentially curative surgery. After tumour resection, 62 patients (41·6 per cent) had a complication within 30 days. Patients who received surgical treatment without tumour resection had a lower complication rate but a significantly higher 30‐day mortality rate than those who underwent tumour resection (10 versus 1·3 per cent respectively; P = 0·002). Of all patients included in the study, 22·3 per cent had potentially curative treatment and the 3‐year survival rate for these patients was 56 per cent.
LRRC is a serious condition with overall poor outcome. Patients undergoing curative surgery have an acceptable survival rate but substantial morbidity. There is room for improvement in the management of patients with LRRC.Full text
You may also be interested in
Authors: R. L. Venchiarutti, M. J. Solomon, C. E. Koh, J. M. Young, D. Steffens
Meta‐analysis of the role of colonoscopy after an episode of left‐sided acute diverticulitis. BJS 2019; 106: 988-997.
Authors: S. J. Rottier, S. T. Dijk, A. A. W. Geloven, W. H. Schreurs, W. A. Draaisma, W. A. Enst et al.
Randomized clinical trial
Multicentre randomized clinical trial of colonic J pouch or straight stapled colorectal reconstruction after low anterior resection for rectal cancer.
Authors: S. Pucciarelli, P. Del Bianco, U. Pace, F. Bianco, A. Restivo, I. Maretto et al.
Authors: T. O. Sillo, A. D. Beggs, D. G. Morton, G. Middleton
Meta‐analysis of the effect of extending the interval after long‐course chemoradiotherapy before surgery in locally advanced rectal cancer.
Authors: É. J. Ryan, D. P. O'Sullivan, M. E. Kelly, A. Z. Syed, P. C. Neary, P. R. O'Connell et al.
Randomized clinical trial
Randomized clinical trial of accelerated enhanced recovery after minimally invasive colorectal cancer surgery (RecoverMI trial).
Authors: B. K. Bednarski, T. P. Nickerson, Y. N. You, C. A. Messick, B. Speer, V. Gottumukkala et al.
Organoids from colorectal peritoneal metastases as a platform for improving hyperthermic intraperitoneal chemotherapy.
Authors: I. Ubink, A. C. F. Bolhaqueiro, S. G. Elias, D. A. E. Raats, A. Constantinides, N. A. Peters et al.
Postoperative complications in relation to overall treatment time in patients with rectal cancer receiving neoadjuvant radiotherapy.
Authors: J. Erlandsson, D. Pettersson, B. Glimelius, T. Holm, A. Martling
Immunogenomic profiles associated with response to neoadjuvant chemoradiotherapy in patients with rectal cancer.
Authors: T. Akiyoshi, N. Tanaka, K. Kiyotani, O. Gotoh, N. Yamamoto, K. Oba et al.
BRAF mutation is not associated with an increased risk of recurrence in patients undergoing resection of colorectal liver metastases.
Authors: J.‐B. Bachet, N. Moreno‐Lopez, L. Vigano, U. Marchese, M. Gelli, L. Raoux et al.
Propensity score‐matched analysis of oncological outcome between stent as bridge to surgery and emergency resection in patients with malignant left‐sided colonic obstruction. BJS 2019; 106: 1075-1086.
Authors: F. J. Amelung, W. A. A. Borstlap, E. C. J. Consten, J. V. Veld, E. E. van Halsema, W. A. Bemelman et al.
Systematic review of outcomes after total neoadjuvant therapy for locally advanced rectal cancer. BJS 2019; 106: 979-987.
Authors: A. Zaborowski, A. Stakelum, D. C. Winter