Organ sparing to cure stage IV rectal cancer: A case report and review of literature.

Autor:	Meillat H; Department of Digestive Surgical Oncology, Institut Paoli Calmettes, Marseille 13009, France. meillath@ipc.unicancer.fr., Garnier J; Department of Digestive Surgical Oncology, Institut Paoli Calmettes, Marseille 13009, France., Palen A; Department of Digestive Surgical Oncology, Institut Paoli Calmettes, Marseille 13009, France., Ewald J; Department of Digestive Surgical Oncology, Institut Paoli Calmettes, Marseille 13009, France., de Chaisemartin C; Department of Digestive Surgical Oncology, Institut Paoli Calmettes, Marseille 13009, France., Tyran M; Department of Radiotherapy, Institut Paoli Calmettes, Marseille 13009, France., Mitry E; Department of Digestive Surgical Oncology, Institut Paoli Calmettes, Marseille 13009, France., Lelong B; Department of Digestive Surgical Oncology, Institut Paoli Calmettes, Marseille 13009, France.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal surgery [World J Gastrointest Surg] 2023 Nov 27; Vol. 15 (11), pp. 2619-2626.
DOI:	10.4240/wjgs.v15.i11.2619
Abstrakt:	Background: Rectal sparing is an option for some rectal cancers with complete or good response after chemoradiotherapy (CRT); however, it has never been evaluated in patients with metastases. We assessed long-term outcomes of a rectal-sparing approach in a liver-first strategy for patients with rectal cancer with resectable liver metastases. Case Summary: We examined patients who underwent an organ-sparing approach for rectal cancer with synchronous liver metastases using a liver-first strategy during 2010-2015 ( n = 8). Patients received primary chemotherapy and pelvic CRT. Liver surgery was performed during the interval between CRT completion and rectal tumor re-evaluation. Clinical and oncological characteristics and long-term outcomes were assessed.All patients underwent liver metastatic resection with curative intent. The R0 rate was 100%. Six and two patients underwent local excision and a watch-and-wait (WW) approach, respectively. All patients had T3N1 tumors at diagnosis and had good clinical response after CRT. The median survival time was 60 (range, 14-127) mo. Three patients were disease free for 5, 8, and 10 years after the procedure. Five patients developed metastatic recurrence in the liver ( n = 5) and/or lungs ( n = 2). Only one patient developed local recurrence concurrent with metastatic recurrence 24 mo after the WW approach. Two patients died during follow-up. Conclusion: The results suggest good local control in patients undergoing organ-sparing strategies for rectal cancer with synchronous liver metastasis. Prospective trials are required to validate these data and identify good candidates for these strategies. Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu