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Surgical Management and Outcomes of Rectal Cancer with Synchronous Prostate Cancer: A Multicenter Experience from the GRECCAR Group

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

Abstract

Background

Synchronous prostate cancer (PC) and rectal cancer (RC) is a rare clinical situation. While combining curative-intent management for both cancers can be challenging, available data for guiding the multidisciplinary strategy are lacking.

Methods

Consecutive patients undergoing rectal resection for a mid-low RC with synchronous PC treated at 9 tertiary-care centers between 2008 and 2018 were included. Management strategy and data on postoperative and long-term outcomes were retrospectively analyzed.

Results

Overall, 25 patients underwent curative-intent RC resection combined with PC management. Nine (36%), 10 (40%) and 6 (24%) patients had low-, intermediate-, and high-risk PC, respectively. Management mostly consisted of chemoradiotherapy combined in 18 patients (72%) with either TME in 12 patients or pelvic exenteration for resection of both cancers in 6 patients. Most patients underwent RC resection using a laparoscopic approach (n = 16, 64%). Anastomosis was performed in 18 patients (72%) of whom 13 received diverting ileostomy. The complete R0 resection rate was 96% (n = 24). The overall morbidity rate was 64% (n = 16) and 5 patients (20%) experienced severe surgical morbidity of which two died within 90 days of surgery after pelvic exenteration. Among patients with anastomosis, 2 patients (11%) experienced anastomotic leak requiring surgical management. After a median follow-up of 31.2 months, 3-year OS and RFS were 80.2% (CI 95% 58.8–92.2) and 68.6% (CI 95% 42.3–84.8), respectively.

Conclusions

This series is the largest to report that simultaneous curative-intent management of synchronous PC and RC is feasible and safe. Pelvic exenteration might be a better option when RC complete resection seems not achievable through TME.

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Acknowledgment

The authors thank Mr Paul Petit (medical dosimetrist) for his technical support.

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Authors and Affiliations

  1. Department of Digestive Surgical Oncology – Liver Transplantation Unit, University Hospital of Besançon, Besançon Cedex, France

    Alexandre Doussot MD, PhD, Bruno Heyd MD, PhD & Zaher Lakkis MD, PhD

  2. Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France

    Dewi Vernerey PhD & Aurélia Meurisse BSc

  3. Department of Colorectal Surgery, Haut-Lévèque Hospital, Pessac, France

    Eric Rullier MD, PhD

  4. Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, Sorbonne Université, Paris, France

    Jérémie H. Lefevre MD, PhD

  5. Department of Digestive Surgical Oncology, Department of Mini Invasive Interventions (DIMI), Paoli Calmettes Institute, Marseille, France

    Hélène Meillat MD

  6. Department of Digestive and Oncological Surgery, Lyon Sud University Hospital, Pierre Bénite, France

    Eddy Cotte MD, PhD

  7. Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France

    Guillaume Piessen MD, PhD

  8. Department of Digestive Surgery, Rouen University Hospital, Rouen, France

    Jean-Jacques Tuech MD, PhD

  9. Department of Colorectal Surgery, Beaujon Hospital, Clichy, France

    Yves Panis MD, PhD

  10. Department of Digestive and General Surgery, Timone Hospital, Marseille, France

    Diane Mege MD, PhD

  11. Department of Radiotherapy, University Hospital of Besançon, Besançon, France

    Berardino De Bari MD, PhD

  12. Department of Radiotherapy, University Hospital of Lausanne, Lausanne, Switzerland

    Berardino De Bari MD, PhD

Authors
  1. Alexandre Doussot MD, PhD
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  2. Dewi Vernerey PhD
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  3. Eric Rullier MD, PhD
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  4. Jérémie H. Lefevre MD, PhD
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  5. Hélène Meillat MD
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  6. Eddy Cotte MD, PhD
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  7. Guillaume Piessen MD, PhD
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  8. Jean-Jacques Tuech MD, PhD
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  9. Yves Panis MD, PhD
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  10. Diane Mege MD, PhD
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  11. Aurélia Meurisse BSc
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  12. Berardino De Bari MD, PhD
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  13. Bruno Heyd MD, PhD
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  14. Zaher Lakkis MD, PhD
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Consortia

French Research Group of Rectal Cancer Surgery (GRECCAR)

Corresponding author

Correspondence to Zaher Lakkis MD, PhD.

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Doussot, A., Vernerey, D., Rullier, E. et al. Surgical Management and Outcomes of Rectal Cancer with Synchronous Prostate Cancer: A Multicenter Experience from the GRECCAR Group. Ann Surg Oncol 27, 4286–4293 (2020). https://doi.org/10.1245/s10434-020-08683-4

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  • DOI: https://doi.org/10.1245/s10434-020-08683-4

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