Locally Recurrent Rectal Cancer: Toward a Second Chance at Cure? A Population-Based, Retrospective Cohort Study

Autor: Hidde Swartjes, Jan M. van Rees, Felice N. van Erning, Marcel Verheij, Cornelis Verhoef, Johannes H. W. de Wilt, Pauline A. J. Vissers, Tijmen Koëter
Přispěvatelé: AII - Cancer immunology, CCA - Cancer biology and immunology, Surgery
Rok vydání: 2023
Předmět:
Zdroj: Annals of Surgical Oncology, 30, 3915-3924
Annals of Surgical Oncology. Springer New York
Annals of Surgical Oncology, 30, 7, pp. 3915-3924
Swartjes, H, van Rees, J M, van Erning, F N, Verheij, M, Verhoef, C, de Wilt, J H W, Vissers, P A J & Koëter, T 2023, ' Locally Recurrent Rectal Cancer : Toward a Second Chance at Cure? A Population-Based, Retrospective Cohort Study ', Annals of Surgical Oncology, vol. 30, no. 7, pp. 3915-3924 . https://doi.org/10.1245/s10434-023-13141-y
ISSN: 3915-3924
1068-9265
DOI: 10.1245/s10434-023-13141-y
Popis: Background In current practice, rates of locally recurrent rectal cancer (LRRC) are low due to the use of the total mesorectal excision (TME) in combination with various neoadjuvant treatment strategies. However, the literature on LRRC mainly consists of single- and multicenter retrospective cohort studies, which are prone to selection bias. The aim of this study is to provide a nationwide, population-based overview of LRRC after TME in the Netherlands. Patients and Methods In total, 1431 patients with nonmetastasized primary rectal cancer diagnosed in the first six months of 2015 and treated with TME were included from the nationwide, population-based Netherlands Cancer Registry. Data on disease recurrence were collected for patients diagnosed in these 6 months only. Competing risk cumulative incidence, competing risk regression, and Kaplan–Meier analyses were performed to assess incidence, risk factors, treatment, and overall survival (OS) of LRRC. Results Three-year cumulative incidence of LRRC was 6.4%; synchronous distant metastases (LRRC-M1) were present in 44.9% of patients with LRRC. Distal localization, R1–2 margin, (y)pT3-4, and (y)pN1-2 were associated with an increased LRRC rate. No differences in LRRC treatment and OS were found between patients who had been treated with or without prior n(C)RT. Curative-intent treatment was given to 42.9% of patients with LRRC, and 3-year OS thereafter was 70%. Conclusions Nationwide LRRC incidence was low. A high proportion of patients with LRRC underwent curative-intent treatment, and OS of this group was high in comparison with previous studies. Additionally, n(C)RT for primary rectal cancer was not associated with differences in treatment and OS of LRRC.
Databáze: OpenAIRE
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