TY - JOUR
T1 - Type of recurrence is associated with disease-free survival after salvage surgery for locally recurrent rectal cancer
AU - Jimenez-Rodriguez, Rosa M.
AU - Yuval, Jonathan B.
AU - Sauve, Charles Etienne Gabriel
AU - Wasserman, Isaac
AU - Aggarwal, Piyush
AU - Romesser, Paul B.
AU - Crane, Christopher H.
AU - Yaeger, Rona
AU - Cercek, Andrea
AU - Guillem, Jose G.
AU - Weiser, Martin R.
AU - Wei, Iris H.
AU - Widmar, Maria
AU - Nash, Garrett M.
AU - Pappou, Emmanouil P.
AU - Garcia-Aguilar, Julio
AU - Gollub, Marc J.
AU - Paty, Philip B.
AU - Smith, J. Joshua
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85111150919
UR - https://www.scopus.com/pages/publications/85111150919#tab=citedBy
U2 - 10.1007/s00384-021-03998-4
DO - 10.1007/s00384-021-03998-4
M3 - Article
C2 - 34296325
AN - SCOPUS:85111150919
SN - 0179-1958
VL - 36
SP - 2603
EP - 2611
JO - International Journal of Colorectal Disease
JF - International Journal of Colorectal Disease
IS - 12
ER -
