Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 20;16(2):448.
doi: 10.3390/cancers16020448.

Late Local Recurrence after Neoadjuvant Therapy and Radical Resection for Locally Advanced Rectal Cancer

Adrian Salega  1 , Marina Münch  1 , Philipp Renner  1 , Klaus-Peter Thon  1 , Wolfgang Steurer  2 , Dina Mönch  3   4 , Jana Koch  3   4 , Annika Maaß  3   4 , Hans Jürgen Schlitt  5 , Marc-Hendrik Dahlke  1 , Tobias Leibold  1
Affiliations

Late Local Recurrence after Neoadjuvant Therapy and Radical Resection for Locally Advanced Rectal Cancer

Adrian Salega et al. Cancers (Basel). .

Abstract

Neoadjuvant radiochemotherapy (RCT) and lately total neoadjuvant therapy (TNT) improved local recurrence rates of rectal cancer significantly compared to total mesorectal excision (TME) alone. Yet the occurrence and impact of late local recurrences after many years appears to be a distinct biological problem. We included n = 188 patients with rectal cancer after RCT and radical resection in this study; n = 38 of which had recurrent disease (sites: local (8.0%), liver (6.4%), lung (3.7%)). We found that 68% of all recurrences developed within the first two years. Four patients, however, experience recurrence >8 years after surgery. Here, we report and characterize four cases of late local recurrence (10% of patients with recurrent disease), suggesting that neoadjuvant therapy in principle delays local recurrence.

Keywords: follow-up; local recurrence; neoadjuvant; outcome; radiochemotherapy; rectal cancer; surveillance.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Curve for cumulative recurrence.
Figure 2
Figure 2
Kaplan–Meier curves for OS, nodal stage.
Figure 3
Figure 3
Kaplan–Meier curves for disease-free-survival, nodal stage.
Figure 4
Figure 4
Kaplan–Meier curves for recurrence.
Figure 5
Figure 5
Kaplan–Meier curves for OS, location of tumor.
Figure 6
Figure 6
Kaplan–Meier curves for disease-free-survival, location of tumor.
Figure 7
Figure 7
CT scan #1.
Figure 8
Figure 8
CT scan #2.
See this image and copyright information in PMC

References

    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA. Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Bujko K., Nowacki M.P., Nasierowska-Guttmejer A., Michalski W., Bębenek M., Pudełko M., Kryj M., Olędzki J., Szmeja J., Słuszniak J., et al. Sphincter Preservation Following Preoperative Radiotherapy for Rectal Cancer: Report of a Randomised Trial Comparing Short-Term Radiotherapy vs. Conventionally Fractionated Radiochemotherapy. Radiother. Oncol. 2004;72:15–24. doi: 10.1016/j.radonc.2003.12.006. - DOI - PubMed
    1. Sauer R., Becker H., Hohenberger W., Rödel C., Wittekind C., Fietkau R., Martus P., Tschmelitsch J., Hager E., Hess C.F., et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N. Engl. J. Med. 2004;21:1731–1740. doi: 10.1056/NEJMoa040694. - DOI - PubMed
    1. Ding P., Liska D., Tang P., Shia J., Saltz L., Goodman K., Downey R.J., Nash G.M., Temple L.K., Paty P.B., et al. Pulmonary Recurrence Predominates after Combined Modality Therapy for Rectal Cancer: An Original Retrospective Study. Ann. Surg. 2012;256:111–116. doi: 10.1097/SLA.0b013e31825b3a2b. - DOI - PubMed
    1. Van Gijn W., Marijnen C.A.M., Nagtegaal I.D., Kranenbarg E.M.K., Putter H., Wiggers T., Rutten H.J.T., Påhlman L., Glimelius B., Van de Velde C.J.H. Preoperative Radiotherapy Combined with Total Mesorectal Excision for Resectable Rectal Cancer: 12-Year Follow-up of the Multicentre, Randomised Controlled TME Trial. Lancet Oncol. 2011;12:575–582. doi: 10.1016/S1470-2045(11)70097-3. - DOI - PubMed

LinkOut - more resources