Recurrence patterns and management of locally recurrent rectal cancer: a retrospective cohort study.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-04-02 DOI:10.1007/s00423-025-03692-x

P Hakenberg, G Kalev, S Seyfried, C Reißfelder, J Hardt

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引用次数: 0

Abstract

Purpose: Treatment of locally recurrent rectal cancer (LRRC) is still challenging because of inhomogeneous patient cohorts regarding previous treatments as well as different recurrence patterns and locations. The aim of this study was to investigate the treatments and surgical approaches tailored to them.

Methods: We included all patients who were treated for LRRC without distant metastasis at the University Medical Center Mannheim, Germany, between 2010 and 2021. We collected data from our electronic clinical data management system regarding the initial diagnosis and treatment, as well as the locations and treatment of the recurrent tumor.

Results: We identified a total of 666 patients who were curatively treated for rectal cancer of whom 36 patients (5.4%) developed LRRC without distant recurrence. Most patients (26/36) had a tailored therapy regimen that included surgery with or without perioperative radiation and/or chemotherapy. The most common site of local relapse was around the former colorectal anastomosis (15/36, 41.7%). The operative procedures ranged from anterior resection to multi-organ resection and exenteration. A complete resection (R0) could be achieved in twelve patients (12/22. 54.5%). The 3- and 5-year overall survival rates were 79% and 72%, respectively.

Conclusion: Most local recurrences occur at the anastomotic site and are mostly eligible for curative surgical therapy with good long-term survival.

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局部复发直肠癌的复发模式和治疗：一项回顾性队列研究。

目的：局部复发直肠癌（LRRC）的治疗仍然具有挑战性，因为既往治疗的患者队列不均匀，以及不同的复发模式和部位。本研究的目的是探讨适合他们的治疗方法和手术方法。方法：我们纳入了2010年至2021年间在德国曼海姆大学医学中心接受无远处转移的LRRC治疗的所有患者。我们从我们的电子临床数据管理系统中收集有关初次诊断和治疗，以及复发肿瘤的位置和治疗的数据。结果：我们共确定了666例接受治愈治疗的直肠癌患者，其中36例（5.4%）发生LRRC，无远处复发。大多数患者（26/36）有量身定制的治疗方案，包括手术加或不加围手术期放疗和/或化疗。局部复发最常见的部位为原结直肠吻合口周围（15/36,41.7%）。手术方式从前路切除到多器官切除和切除。12例患者（12/22）完全切除（R0）。54.5%)。3年和5年总生存率分别为79%和72%。结论：局部复发多发生在吻合口，手术治疗疗效好，远期生存率高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.