Treatment and survival of locally recurrent rectal cancer: A cross-sectional population study 15 years after the Dutch TME trial |
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| Affiliation: | 1. Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands;2. Leiden University Medical Center, Department of Surgery, Leiden, the Netherlands;3. Netherlands Cancer Institute-Antoni van Leeuwenhoek, Department of Radiotherapy, Amsterdam, the Netherlands;4. Netherlands Cancer Institute-Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, the Netherlands;1. Republican Centre for Thyroid Tumours, Department of Pathology, Nezavisimosty Av., 64, 220013, Minsk, Belarus;2. Republican Centre for Thyroid Tumours, Head and Neck Surgery Department, Nezavisimosty Av., 64, 220013, Minsk, Belarus;3. United Institute of Informatics Problems, National Academy of Sciences of Belarus, Surganova St. 6, 220012, Minsk, Belarus;4. New York Ear, Nose and Throat Institute, 1810 Voorhies Ave, Brooklyn, NY, 11235, United States;5. Department of Surgery, University of Hong Kong, Hong Kong;6. School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia;1. Department of Obstetrics and Gynecology, Spedali Civili of Brescia, Piazzale Spedali Civili 1, Brescia, 25126, Italy;2. Department of Obstetrics and Gynecology, University of Brescia, Italy;3. Department of Pathology, Spedali Civili of Brescia, Italy;4. Department of Radiotherapy, Spedali Civili of Brescia, Italy;1. Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, India;2. Institute of Experimental Endocrinology Oncology, Naples, Italy;3. Department of Pathology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, India;1. Division of Gastroenterology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea;2. Center for Liver Cancer, National Cancer Center, Goyang, South Korea;3. Cancer Big Data Center, National Cancer Control Institute, National Cancer Center, Goyang, South Korea;4. Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, South Korea;1. Scandinavian Surgical Outcomes Research Group (SSORG), Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 416 85, Gothenburg, Sweden;2. Region Västra Götaland, Sahlgrenska University Hospital, Department of Pediatric Oncology, 416 85, Gothenburg, Sweden;3. Region Västra Götaland, Sahlgrenska University Hospital, Department of Surgery, 416 85, Gothenburg, Sweden;4. Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, 405 30, Gothenburg, Sweden;5. Center for Health and Performance, Institute of Food, Nutrition, and Sports Science, University of Gothenburg, 405 30, Gothenburg, Sweden;6. Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine, Geriatrics, and Emergency Medicine, 416 85, Gothenburg, Sweden;7. Health Metrics Unit, The Sahlgrenska Academy, University of Gothenburg, Sweden |
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| Abstract: | IntroductionOptimized treatment of primary rectal cancer might have influenced treatment characteristics and outcome of locally recurrent rectal cancer (LRRC). Subgroup analysis of the Dutch TME trial showed that preoperative radiotherapy (PRT) for the primary tumour was an independent poor prognostic factor after diagnosis of LRRC. This cross-sectional population study aimed to evaluate treatment and overall survival (OS) of LRRC patients, stratified for prior preoperative radiotherapy (PRT) and intention of treatment of LRRC.MethodsAll patients developing LRRC were selected from a collaborative Snapshot study on 2095 surgically treated rectal cancer patients from 71 Dutch hospitals in the year 2011. Cox proportional hazard analysis was performed to determine predictors for OS.ResultsA total of 107 LRRC patients (5.1%) were included, of whom 88 (82%) underwent PRT for their primary tumour. LRRC was treated with initial curative intent in 31 patients (29%), with eventual resection in 20 patients (19%). Median OS was 22 and 8 months after curative and palliative intent treatment, respectively (p < 0.001). Initial CRM positivity and palliative intent treatment were associated with worse OS after LRRC, while prior PRT was not.ConclusionsThis cross-sectional study revealed that rectal cancer patients, who underwent curative resection in the Netherlands in 2011 and subsequently developed local recurrence, were amenable for again curative intent treatment in 29%, with a corresponding median survival of 22 months. Prior PRT was not significantly associated with survival after diagnosis of LRRC. |
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| Keywords: | Rectal neoplasms Neoplasm recurrence Local Outcome and process assessment (health care) Treatment outcome Radiotherapy Prognosis Survival |
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