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Preoperative Chemoradiation Followed by Extensive Pelvic Surgery Improved the Outcome of Posterior Invasive Locally Recurrent Rectal Cancer without Deteriorating Surgical Morbidities: A Retrospective, Single-Institution Analysis

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The main feature of locally recurrent rectal cancer (LRRC) is infiltrating growth; thus, preoperative chemoradiation therapy (preCRT) is recommended to improve patient outcomes. However, no studies have reported the potential impact of preCRT on oncological and surgical outcomes in posterior invasive LRRC (piLRRC) that requires sacrectomy.

Methods

Forty-one patients with piLRRC were treated with (n = 25) or without (n = 16) preCRT. Oncological outcomes regarding local re-recurrence-free survival, distant metastasis-free survival, and overall survival (OS) were analyzed. Surgical complications were assessed using the Clavien–Dindo scale.

Results

The preCRT group had higher 5-year local re-recurrence-free survival (24.4 vs. 0 %) and OS (46.6 vs. 29.3 %) than the non-preCRT group. Univariate analysis demonstrated that preCRT (p = 0.03) and microlymphatic involvement (p = 0.01) were significantly related to local re-recurrence. Microlymphatic involvement occurred less frequently in the preCRT group than in the non-preCRT group (23.8 vs. 71.4 %; p = 0.01) despite the similarity in primary cancers between groups. Major infectious complications occurred with similar frequency in the preCRT and non-preCRT groups (24 vs. 18.8 %, p = 1).

Conclusions

PreCRT significantly benefited oncological outcome without compromising surgical results for piLRRC.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate school of Medicine, Osaka University, Suita, Japan

    Hisataka Ogawa MD, Mamoru Uemura MD, PhD, Junichi Nishimura MD, PhD, Taishi Hata MD, PhD, Ichiro Takemasa MD, PhD, Tsunekazu Mizushima MD, PhD, Hirofumi Yamamoto MD, PhD, Yuichiro Doki MD, PhD & Masaki Mori MD, PhD

  2. Department of Surgery, Osaka Rosai Hospital, Sakai, Japan

    Masakazu Ikenaga MD, PhD

  3. Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan

    Masataka Ikeda MD, PhD & Mitsugu Sekimoto MD, PhD

Authors
  1. Hisataka Ogawa MD
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  2. Mamoru Uemura MD, PhD
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  3. Junichi Nishimura MD, PhD
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  4. Taishi Hata MD, PhD
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  5. Masakazu Ikenaga MD, PhD
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  6. Ichiro Takemasa MD, PhD
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  8. Masataka Ikeda MD, PhD
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  9. Mitsugu Sekimoto MD, PhD
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  10. Hirofumi Yamamoto MD, PhD
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Corresponding author

Correspondence to Mamoru Uemura MD, PhD.

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Ogawa, H., Uemura, M., Nishimura, J. et al. Preoperative Chemoradiation Followed by Extensive Pelvic Surgery Improved the Outcome of Posterior Invasive Locally Recurrent Rectal Cancer without Deteriorating Surgical Morbidities: A Retrospective, Single-Institution Analysis. Ann Surg Oncol 22, 4325–4334 (2015). https://doi.org/10.1245/s10434-015-4452-0

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  • DOI: https://doi.org/10.1245/s10434-015-4452-0

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