Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Treatment Planning, Diagnostic Examinations
2.3. Treatment
2.4. Follow-Up
2.5. Local Recurrence
2.6. Statistical Analysis
3. Results
3.1. Patients
3.2. Local Recurrence after Treatment for Rectal Cancer
3.3. Treatment of Local Recurrence
3.4. Survival after Local Recurrence Incidence
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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No Recurrence | Local Recurrence | p | |
---|---|---|---|
N = 338 | N = 27 | ||
n (%) | n (%) | ||
Sex | <0.05 | ||
Male | 192 (56.8) | 7 (25.9) | |
Female | 146 (43.2) | 20 (74.1) | |
Age, years median/range | 64 (33–90) | 62 (44–86) | NS |
Surgical procedure | |||
Dixon | 213 (63.0) | 15 (55.5) | NS |
Miles | 118 (35.0) | 11 (41.0) | |
Hartmann’s | 7 (2.1) | 1 (3.7) | |
Re-operation | 25 (7.4) | 2 (7.4) | NS |
Surgical complications | 92 (27.2) | 8 (29.6) | NS |
(30 days postoperative) | |||
Average tumor size, mm | 39.6 | 39.1 | NS |
Distance from the anal verge, cm | 7 (1–15) | 5.5 (1–15) | |
˂6 | 141 (41.7) | 17 (63.0) | NS |
7–12 | 146 (43.2) | 8 (29.6) | |
13–15 | 21 (6.2) | 1 (3.7) | |
No data or data incomplete | 30 | 1 | |
Clinical stage (ypTNM/pTNM) | NS | ||
I | 86 (25.4) | 3 (11.1) | |
II | 107 (31.7) | 9 (33.3) | |
III | 139 (41.1) | 14 (51.8) | |
pCR | 6 (1.8) | 1 (3.7) |
Total N = 365 n (%) | Local Recurrence N = 27 n (%) | All Recurrences % | |
---|---|---|---|
No RT | 71 (19.4) | 8 (29.6) | 11 |
Preoperative RT | |||
spRT | 214 (58.6) | 9 (33.3) | 4 |
pCRT | 20 (5.5) | 4 (14.8) | 20 |
pRT | 30 (8.2) | 3 (11.1) | 10 |
Postoperative RT | |||
poRT | 26 (7.1) | 3 (11.1) | 11 |
Others * | 4 (1.1) | 0 | 0 |
Stage ypTNM/pTNM | Without Recurrence N = 338 n (%) | With Local Recurrence N = 27 n (%) | Total N = 365 n (%) | % Recurrence | RT/−/ N = 71 n (%) | W RT/−/ LR− N = 63 n (%) | RT/−/ LR+ N = 8 n (%) | % Recurrence RT/−/ |
---|---|---|---|---|---|---|---|---|
T0N0 | 6 (1.8) | 1 (3.7) | 7 (1.9) | 14.3 | 0 | 0 | 0 | |
T0N1 | 1 (0.3) | 0 | 1 (0.3) | 0 | 0 | 0 | 0 | |
T1N0 | 14 (4.1) | 0 | 14 (3.8) | 0 | 10 (14.8) | 0 | 0 | |
T2N0 | 73 (21.6) | 3 (11.1) | 76 (20.8) | 3.9 | 20 (28.2) | 17 (26.9) | 3 (37.5) | 15 |
T2N1 | 21 (6.2) | 2 (3.7) | 23 (6.3) | 8.7 | 4 (5.6) | 4 (63.5) | 0 | 0 |
T2N2 | 17 (5.0) | 1 (3.7) | 18 (4.9) | 5.5 | 3 (4.2) | 3 (4.8) | 0 | 0 |
T3N0 | 98 (29.0) | 8 (29.6) | 106 (29.0) | 7.5 | 19 (26.8) | 17 (26.9) | 2 (25) | 10.5 |
T3N1 | 52 (15.4) | 4 (14.8) | 56 (15.3) | 7.1 | 11 (15.5) | 10 (15.9) | 1 (12.5) | 9.0 |
T3N2 | 38 (11.2) | 2 (7.4) | 40 (10.9) | 5.0 | 4 (5.6) | 3 (4.8) | 1 (12.5) | 25.0 |
T4N0 | 10 (3.0) | 1 (3.7) | 11 (3.0) | 9.0 | 1 (1.4) | 1 (1.6) | 0 | 0 |
T4N1 | 5 (1.5) | 1 (3.7) | 6 (1.6) | 16.7 | 1 (1.4) | 1 (1.6) | 0 | 0 |
T4N2 | 3 (1.9) | 4 (14.8) | 7 (1.9) | 57.1 | 1 (1.4) | 1 (1.6) | 1 (12.5) | 100 |
Location | N (*) | % (*) | RT/CRT Scheduling | |||
---|---|---|---|---|---|---|
No RT | sRT | pCRT/pRT | poRT | |||
n (*) | n (*) | n (*) | n (*) | |||
Central | ||||||
Anastomosis | 5 (4) | 18.5 (36) | 3 (2) | 1 (1) | 1 (1) | - |
Rectal stump | 1 (1) | 3.7 (9) | - | 1 | - | |
Perineum | 3 (2) | 11.1 (18) | 1 | 2 (2) | - | |
Front | ||||||
Vagina | 4 (1) | 14.8 (9) | 2 | 2 | - | - |
Bladder | 1 (0) | 3.7 (0) | - | 1 | - | - |
Posterior | ||||||
Presacral space | 7 (3) | 25.9 (27) | 2 (1) | 2 (1) | 1 | 2 (1) |
Side | ||||||
Pelvic sidewall | 6 (2) | 22.2 (18) | - | 1 | 4 (2) | 1 |
Total | 27 (11) | 100 (100) | 8 (3) | 9 (4) | 8 (2) | 2 (1) |
n | Median OS after PT | p | Median OS after LRT | p | |
---|---|---|---|---|---|
Months (Range) | Months (Range) | ||||
Type of recurrence | |||||
Isolated | 11 | 53 (9–161) | 0.416 | 21 (2–119) | 0.779 |
Combined | 16 | 45 (9–149) | 18 (2–116) | ||
All | 27 | 47 (9–161) | 19 (2–119) | ||
Site | |||||
Combined + isolated | 27 | ||||
Central | 9 | 37 (9–161) | 21 (1–119) | ||
Anastomotic | 5 | 65 (25–161) | 23 (21–119) | ||
Perineal | 3 | 11 (9–19) | 2 (2–6) | ||
Anterior | 5 | 48 (38–84) | 25 (18–59) | ||
Posterior | 7 | 47 (20–74) | 17 (3–40) | ||
Lateral | 6 | 42 (24–110) | 13 (7–36) | ||
Isolated | 11 | ||||
Central | 5 | 25 (9–161) | 21 (2–119) | ||
Anastomotic | 3 | 53 (25–161) | 23 (21–119) | ||
Perineal | 2 | 14 (9–19) | 4 (2–6) | ||
Anterior | 1 | 84 (84) | 59 (59) | ||
Posterior | 3 | 72 (34–74) | 17 (3–22) | ||
Lateral | 2 | 67 (24–110) | 21 (7–36) | ||
Procedures | |||||
Palliative surgical procedures | 4 | 42 (19–65) | 14 (7–24) | ||
Non radical resection | 2 | 42 (19–65) | 14 (6–23) | ||
Radical resection | 6 | 48 (25–161) | 34 (15–119) | ||
RT/CT | 9 | 56 (34–110) | 19 (3–59) | ||
Observation | 6 | 34 (9–72) | 4 (2–23) |
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Jankowski, M.; Las-Jankowska, M.; Rutkowski, A.; Bała, D.; Wiśniewski, D.; Tkaczyński, K.; Kowalski, W.; Głowacka-Mrotek, I.; Zegarski, W. Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study. Medicina 2021, 57, 286. https://doi.org/10.3390/medicina57030286
Jankowski M, Las-Jankowska M, Rutkowski A, Bała D, Wiśniewski D, Tkaczyński K, Kowalski W, Głowacka-Mrotek I, Zegarski W. Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study. Medicina. 2021; 57(3):286. https://doi.org/10.3390/medicina57030286
Chicago/Turabian StyleJankowski, Michał, Manuela Las-Jankowska, Andrzej Rutkowski, Dariusz Bała, Dorian Wiśniewski, Karol Tkaczyński, Witold Kowalski, Iwona Głowacka-Mrotek, and Wojciech Zegarski. 2021. "Clinical Reality and Treatment for Local Recurrence of Rectal Cancer: A Single-Center Retrospective Study" Medicina 57, no. 3: 286. https://doi.org/10.3390/medicina57030286