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Factors predicting recurrence after curative resection for rectal cancer: a 16-year study.

ABSTRACT: BACKGROUND:The recurrence after curative surgery of the rectal adenocarcinoma is a serious complication, considered as a failure of the therapeutic strategy. The aim of this study was to identify the different prognostic factors affecting the recurrence of adenocarcinoma of the rectum. METHODS:A retrospective analysis of patients operated for adenocarcinoma of the rectum between January 2000 and December 2015 was conducted. The study of the recurrence rate and prognostic factors was performed through the Kaplan Meier survival curve and the Cox regression analysis. RESULTS:During the study period, 188 patients underwent curative surgery for rectal adenocarcinoma, among which 53 had a recurrence. The recurrence rate was 44.6% at 5?years. The multivariate analysis identified four parameters independently associated with the risk of recurrence after curative surgery: a distal margin ??2?cm (HR?=?6.8, 95% CI 2.7-16.6, 6), extracapsular invasion of lymph node metastasis (HR?=?4.4, 95% CI 1.3-14), tumor stenosis (HR?=?4.3, 95% CI 1.2-15.2), and parietal invasion (pT3/T4 disease) (HR?=?3, 95% CI 1.1-9.4). CONCLUSION:The determination of the prognostic factors affecting the recurrence of rectal adenocarcinoma after curative surgery allows us to define the high-risk patients for recurrence. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT03899870 . Registered on 2 February 2019, retrospectively registered.

SUBMITTER: Farhat W

PROVIDER: S-EPMC6819540 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Factors predicting recurrence after curative resection for rectal cancer: a 16-year study.

Farhat Waad W Azzaza Mohamed M Mizouni Abdelkader A Ammar Houssem H Ben Ltaifa Mahdi M Lagha Sami S Kahloul Mohamed M Gupta Rahul R Mabrouk Mohamed Ben MB Ali Ali Ben AB

World journal of surgical oncology 20191028 1

<h4>Background</h4>The recurrence after curative surgery of the rectal adenocarcinoma is a serious complication, considered as a failure of the therapeutic strategy. The aim of this study was to identify the different prognostic factors affecting the recurrence of adenocarcinoma of the rectum.<h4>Methods</h4>A retrospective analysis of patients operated for adenocarcinoma of the rectum between January 2000 and December 2015 was conducted. The study of the recurrence rate and prognostic factors w ...[more]

PMID: 31660992

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Project description:BACKGROUND:High-quality randomized controlled trials have demonstrated the benefit of radiotherapy (RT) in patients with radical resected gastric cancer (GC), however, utilization rates of postoperative RT remain remarkably low. Patterns, incidences, and time of recurrence provide biological bases for clinical monitoring of GC patients and guiding potential complementary therapies. Thus, the aim of this study is to understand the location of locoregional recurrence which may allow individualized RT strategies and minimize radiation-related toxic effects. METHODS:A relatively large sample of GC patients in a single institution who had undergone curative D2 resection was retrospectively reviewed and the relevant recurrence patterns were illustrated. Independent recurrence-related risk factors were analyzed by logistic regression analysis. New logistic regression models were further developed to predict the probability of recurrence. RESULTS:Overall, among 776 GC patients who had continuous and complete follow-up data, 300 cases relapsed after curative resection. Lymphovascular invasion, lymph node metastases, and tumor stage were indicators for early recurrence. Peritoneal, regional, local, and distant recurrence initially occurred in 51 (6.6%), 151 (19.4%), 56 (7.2%), and 164 (21.1%) patients, respectively. Among patients with regional recurrence, the most common sites were lymph node stations 16a2, 8, 12, 16b1, and 9. Remnant stomach recurrence was not so prominent that it seemed reasonable to be excluded from an irradiation field for patients with negative surgical/pathologic margins. CONCLUSIONS:For GC patients who underwent radical D2 resection, distant and regional recurrences were still common. Besides, optimizing regional control of lymph nodes outside the D2 dissected area was crucial for rational design of the RT field. Furthermore, the new logistic regression models might act as useful tools to evaluate recurrence risk and determine which patients should receive postoperative chemoradiotherapy.

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Factors predicting recurrence after curative resection for rectal cancer: a 16-year study.

Publications

Factors predicting recurrence after curative resection for rectal cancer: a 16-year study.

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