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Predictors of Successful Salvage Surgery for Local Pelvic Recurrence of Rectosigmoid Colon and Rectal Cancers

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Abstract

Purpose

We investigated the predictors of successful resection of recurrent tumors and improved survival in patients with local pelvic recurrence of rectosigmoid colon and rectal cancer.

Methods

We analyzed the clinicopathological factors of 94 patients who underwent treatment between 1993 and 2002 for the local pelvic recurrence of curatively resected primary rectosigmoid colon and rectal adenocarcinoma.

Results

Of the 94 patients, 48 underwent salvage surgery and 46 were treated conservatively. The survival rate of the patients who underwent salvage surgery was significantly higher than that of those treated conservatively (P < 0.0001). Logistic regression analysis revealed that the following factors were significantly associated with successful salvage surgery: tumor differentiation (well or moderately; P < 0.04), a long interval between the initial operation and the detection of recurrence (P < 0.03), and negative lymph node status at the initial operation (P < 0.02). The Cox proportional hazard model revealed the following predictors of better survival after surgery: tumor differentiation (well and moderate), negative lymph node status at the initial operation (pN0), and a perianastomotic pattern of recurrence.

Conclusion

The predictors of successful salvage surgery are the tumor differentiation and nodal status of the primary tumor, the interval between the initial operation and the detection of recurrence, and the pattern of tumor recurrence.

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References

  1. AR Rao AR Kagan PM Chan HA Gilbert H Nussbaum BL Hints (1981) ArticleTitlePatterns of recurrence following curative resection alone for adenocarcinoma of the rectum and sigmoid colon Cancer 48 1492–5 Occurrence Handle7272970 Occurrence Handle10.1002/1097-0142(19810915)48:6<1492::AID-CNCR2820480636>3.0.CO;2-K Occurrence Handle1:STN:280:Bi2D3c7ptFI%3D

    Article  PubMed  CAS  Google Scholar 

  2. SJ Pilipshen M Heilweil SH Quan SS Sternberg WE Enker (1984) ArticleTitlePatterns of pelvic recurrence following definitive resections of rectal cancer Cancer 53 1354–62 Occurrence Handle6692324 Occurrence Handle10.1002/1097-0142(19840315)53:6<1354::AID-CNCR2820530623>3.0.CO;2-J Occurrence Handle1:STN:280:BiuC3cnjvVY%3D

    Article  PubMed  CAS  Google Scholar 

  3. FT McDermott ES Hughes E Pihl WR Johnson AB Price (1985) ArticleTitleLocal recurrence after potentially curative resection for rectal cancer in a series of 1008 patients Br J Surg 72 34–7 Occurrence Handle3967128 Occurrence Handle10.1002/bjs.1800720115 Occurrence Handle1:STN:280:BiqD1Mfkt1U%3D

    Article  PubMed  CAS  Google Scholar 

  4. RK Phillips R Hittinger L Blesovsky JS Fry LP Fielding (1984) ArticleTitleLocal recurrence following “curative” surgery for large bowel cancer: II. The rectum and rectosigmoid Br J Surg 71 17–20 Occurrence Handle6689963 Occurrence Handle10.1002/bjs.1800710105 Occurrence Handle1:STN:280:BiuD1c7jtVY%3D

    Article  PubMed  CAS  Google Scholar 

  5. G Gagliardi PR Hawley MJ Hershman SJ Arnott (1995) ArticleTitlePrognostic factors in surgery for local recurrence of rectal cancer Br J Surg 82 1401–5 Occurrence Handle7489178 Occurrence Handle10.1002/bjs.1800821035 Occurrence Handle1:STN:280:BymD1Mjotlw%3D

    Article  PubMed  CAS  Google Scholar 

  6. RM Olson NP Perencevich AW Malcolm JT Chaffey RE Wilson (1980) ArticleTitlePatterns of recurrence following curative resection of adenocarcinoma of the colon and rectum Cancer 45 2969–74 Occurrence Handle7388740 Occurrence Handle10.1002/1097-0142(19800615)45:12<2969::AID-CNCR2820451214>3.0.CO;2-7 Occurrence Handle1:STN:280:Bi%2BB383ksVc%3D

    Article  PubMed  CAS  Google Scholar 

  7. AM Abulafi NS Williams (1994) ArticleTitleLocal recurrence of colorectal cancer: the problem, mechanisms, management and adjuvant therapy Br J Surg 81 7–19 Occurrence Handle8313126 Occurrence Handle10.1002/bjs.1800810106 Occurrence Handle1:STN:280:ByuC2cjhtVE%3D

    Article  PubMed  CAS  Google Scholar 

  8. LH Sobin Ch Wittekind (Eds) (2002) UICC TNM classification of malignant tumors EditionNumber6th edn Wiley–Liss New York 72–6

    Google Scholar 

  9. JP Welch GA Donaldson (1978) ArticleTitleDetection and treatment of recurrent cancer of the colon and rectum Am J Surg 135 505–11 Occurrence Handle637196 Occurrence Handle10.1016/0002-9610(78)90028-4 Occurrence Handle1:STN:280:CSeC2c3ksFE%3D

    Article  PubMed  CAS  Google Scholar 

  10. HJ Wanebo RJ Koness MP Vezeridis SI Cohen DE Wrobleski (1994) ArticleTitlePelvic resection of recurrent rectal cancer Ann Surg 220 586–95 Occurrence Handle7524455 Occurrence Handle10.1097/00000658-199410000-00017 Occurrence Handle1:STN:280:ByqD3s7jsFM%3D

    Article  PubMed  CAS  Google Scholar 

  11. D Hahnloser H Nelson LL Gunderson I Hassan MG Haddock MJ O'Connell et al. (2003) ArticleTitleCurative potential of multimodality therapy for locally recurrent rectal cancer Ann Surg 237 502–8 Occurrence Handle12677146 Occurrence Handle10.1097/00000658-200304000-00011

    Article  PubMed  Google Scholar 

  12. JC Salo PB Paty J Guillem BD Minsky LB Harrison AM Cohen (1999) ArticleTitleSurgical salvage of recurrent rectal carcinoma after curative resection: a 10-year experience Ann Surg Oncol 6 171–7 Occurrence Handle10082043 Occurrence Handle10.1007/s10434-999-0171-8 Occurrence Handle1:STN:280:DyaK1M7otVSrsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  13. K Suzuki RR Dozois RM Devine H Nelson AL Weaver LL Gunderson et al. (1996) ArticleTitleCurative reoperations for locally recurrent rectal cancer Dis Colon Rectum 39 730–6 Occurrence Handle8674362 Occurrence Handle10.1007/BF02054435 Occurrence Handle1:STN:280:BymB1M%2FlsFw%3D

    Article  PubMed  CAS  Google Scholar 

  14. F Lopez-Kostner VW Fazio A Vignali LA Rybicki IC Lavery (2001) ArticleTitleLocally recurrent rectal cancer: predictors and success of salvage surgery Dis Colon Rectum 44 173–8 Occurrence Handle11227932 Occurrence Handle10.1007/BF02234289 Occurrence Handle1:STN:280:DC%2BD3M7ot1Sltg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  15. AR Miller SB Cantor GE Peoples DB Pearlstone JM Skibber (2000) ArticleTitleQuality of life and cost effectiveness analysis of therapy for locally recurrent rectal cancer Dis Colon Rectum 43 1695–701 Occurrence Handle11156453 Occurrence Handle10.1007/BF02236852 Occurrence Handle1:STN:280:DC%2BD3M%2FpvFGqsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  16. L Rosen MC Veidenheimer JA Coller ML Corman (1982) ArticleTitleMortality, morbidity, and patterns of recurrence after abdominoperineal resection for cancer of the rectum Dis Colon Rectum 25 202–8 Occurrence Handle7067559 Occurrence Handle10.1007/BF02553101 Occurrence Handle1:STN:280:Bi2C28visFw%3D

    Article  PubMed  CAS  Google Scholar 

  17. T Rich LL Gunderson R Lew JJ Galdibini AM Cohen G Donaldson (1983) ArticleTitlePatterns of recurrence of rectal cancer after potentially curative surgery Cancer 52 1317–29 Occurrence Handle6192900 Occurrence Handle10.1002/1097-0142(19831001)52:7<1317::AID-CNCR2820520731>3.0.CO;2-6 Occurrence Handle1:STN:280:BiyB1cvnvV0%3D

    Article  PubMed  CAS  Google Scholar 

  18. N Saito K Koda N Takiguchi K Oda M Ono M Sugito et al. (2003) ArticleTitleCurative surgery for local pelvic recurrence of rectal cancer Dig Surg 20 192–9 Occurrence Handle12759498 Occurrence Handle10.1159/000070385

    Article  PubMed  Google Scholar 

  19. J Garcia-Aguilar JW Cromwell C Marra SH Lee RD Madoff DA Rothenberger (2001) ArticleTitleTreatment of locally recurrent rectal cancer Dis Colon Rectum 44 1743–8 Occurrence Handle11742153 Occurrence Handle10.1007/BF02234449 Occurrence Handle1:STN:280:DC%2BD3MjgtV2jsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  20. DJ Bruinvels AM Stiggelbout J Kievit HC van Houwelingen JD Habbema CJ van de Velde (1994) ArticleTitleFollow-up of patients with colorectal cancer: a meta-analysis Ann Surg 219 174–82 Occurrence Handle8129488 Occurrence Handle10.1097/00000658-199402000-00009 Occurrence Handle1:STN:280:ByuC2srmtlw%3D

    Article  PubMed  CAS  Google Scholar 

  21. M Huguier S Houry (1998) ArticleTitleTreatment of local recurrence of rectal cancer Am J Surg 175 288–92 Occurrence Handle9568653 Occurrence Handle10.1016/S0002-9610(98)00016-6 Occurrence Handle1:STN:280:DyaK1c3islKjtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  22. G Secco (1999) ArticleTitleIs intensive follow-up really able to improve prognosis of patients with local recurrence after curative surgery for rectal cancer? Ann Surg Oncol 7 32–7 Occurrence Handle10.1007/s10434-000-0032-y

    Article  Google Scholar 

  23. M Rubbini GF Vettorello C Guerrera C Mari D De Anna F Mascoli et al. (1990) ArticleTitleA prospective study of local recurrence after resection and low stapled anastomosis in 183 patients with rectal cancer Dis Colon Rectum 33 117–21 Occurrence Handle2298097 Occurrence Handle10.1007/BF02055539 Occurrence Handle1:STN:280:By%2BC38nhtVU%3D

    Article  PubMed  CAS  Google Scholar 

  24. MW Stearns SuffixJr (1980) ArticleTitleDiagnosis and management of recurrent pelvic malignancy following combined abdominoperineal resection Dis Colon Rectum 23 359–61 Occurrence Handle7398513 Occurrence Handle10.1007/BF02586848

    Article  PubMed  Google Scholar 

  25. G Steele SuffixJr TS Ravikumar PN Benotti (1990) ArticleTitleNew surgical treatments for recurrent colorectal cancer Cancer 65 IssueID3 Suppl 723–30 Occurrence Handle1689208 Occurrence Handle10.1002/1097-0142(19900201)65:3+<723::AID-CNCR2820651317>3.0.CO;2-U

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Colorectal and Pelvic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Akihiko Kobayashi, Masanori Sugito, Masaaki Ito & Norio Saito

Authors
  1. Akihiko Kobayashi
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  2. Masanori Sugito
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  3. Masaaki Ito
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  4. Norio Saito
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Kobayashi, A., Sugito, M., Ito, M. et al. Predictors of Successful Salvage Surgery for Local Pelvic Recurrence of Rectosigmoid Colon and Rectal Cancers. Surg Today 37, 853–859 (2007). https://doi.org/10.1007/s00595-007-3518-4

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  • DOI: https://doi.org/10.1007/s00595-007-3518-4

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