Follow-up After Potentially Curative Therapy for Rectal Cancer

2001 ◽  
pp. 135-146
Author(s):  
D. E. Nadig ◽  
K. S. Virgo ◽  
W. E. Longo ◽  
F. E. Johnson
Keyword(s):  
Rectal Cancer ◽  
Curative Therapy

Does post-treatment surveillance imaging improve outcomes in patients with locally advanced rectal cancer?

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 548-548
Author(s):  
Michael Wahl ◽  
Daphne A. Haas-Kogan ◽  
Moshiur Mekhail Anwar ◽  
Alan P. Venook
Keyword(s):  
Rectal Cancer ◽  
False Positive ◽  
Distant Metastases ◽  
Post Treatment ◽  
Definitive Treatment ◽  
Curative Intent ◽  
Curative Therapy ◽  
Surveillance Imaging ◽  
Imaging Results

548 Background: The optimal post-treatment surveillance strategy for pts with rectal cancer is undefined. Trials examining surveillance with serial CEA measurements and/or imaging for colorectal cancer have yielded conflicting results, and no prospective trials have been done specific to rectal cancer pts. In the absence of data, reputable guidelines advocate serial chest, abdomen and pelvic imaging, CEA and colonoscopy after definitive treatment of rectal cancer. The rationale is to identify recurrence before it is symptomatic: if local, to avoid morbidity and if distant, because of the possibility of curative therapy. However, frequent imaging raises concerns regarding radiation exposure, consequences from false-positive findings, and cost. Methods: We performed a retrospective cohort study of patients with stage II/III rectal cancer treated definitively with neoadjuvant chemoradiation followed by surgical resection over the past 10 years. CEA, imaging studies and colonoscopies were recorded for all pts with follow-up of at least 6 months, along with clinical endpoints of locoregional recurrence, development of distant metastases, nature of subsequent therapies, and survival. Results: 55 pts with complete follow-up data were identified (median follow-up, 3.2 years). Surveillance was performed with imaging, CEA and colonoscopy in 89%, 72% and 49% of pts, respectively. 6 local recurrences were identified (11%): two were diagnosed via surveillance imaging, 3 underwent surgery with curative intent, with one patient with no evidence of disease at last follow-up. In contrast, 13 pts (24%) developed distant metastases (6 liver, 5 lung, 2 diffuse metastases), of which 9 were detected on surveillance imaging, 7 underwent therapy with curative intent, and 6 had no evidence of disease at last follow-up. There were 8 false-positive imaging results, 2 of which resulted in unnecessary surgery. Conclusions: Our findings suggest that post-treatment surveillance imaging is useful for detecting oligometastatic disease amenable to curative therapy, but may be less so for locoregional recurrences. Prospective data is needed to further assess the utility of post-treatment imaging in this population.

The Ferguson Operating Anoscope for Resection of T1 Rectal Cancer

2016 ◽  
Vol 82 (11) ◽  
pp. 1105-1108
Author(s):  
Kristin C. Turza ◽  
Thomas Brien ◽  
Steven Porbunderwala ◽  
Christopher M. Bell ◽  
Shauna Lorenzo-rivero ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anal Verge ◽  
Tertiary Care ◽  
Primary Lung Cancer ◽  
Disease Free Survival ◽  
Rectal Tumors ◽  
Salvage Operation ◽  
T1 Rectal Cancer

The Ferguson Operating Anoscope (FOA) is a surgical instrument, which can facilitate transanal excision of appropriate rectal tumors within 15 cm of the anal verge. Previous work showed low recurrence (4.3%) for favorable T1 tumors (no lymphovascular invasion, well/moderate differentiation, negative margins). This follow-up study evaluates outcomes in rectal cancer excised with FOA at a tertiary care center. T1 rectal cancer patients were identified in a prospectively maintained database. Tumor pathology and patient characteristics were reviewed. Primary outcomes include tumor recurrence and patient and disease-free survival. Secondary outcomes are quality of excision (intact specimen). Twenty-eight patients had pathologic stage T1 rectal cancer (average 8 ± 2.6 cm from the anal verge). Final path demonstrated 14 per cent to be well differentiated, 82 per cent moderately differentiated, and 93 per cent without angiolymphatic invasion. All specimens removed were intact. One patient had a true local recurrence and underwent a salvage operation 24 months after her index operation. Patient survival was 96.4 per cent (n = one death from primary lung cancer) at median follow-up 64 ± 35 months. With appropriate tumor selection and quality of initial resection, FOA has demonstrated utility in achieving optimal oncologic resection of T1 rectal tumors.

The role of imaging in the pre-operative staging and post-operative follow-up of rectal cancer

The Surgeon ◽  
2008 ◽  
Vol 6 (4) ◽  
pp. 222-231 ◽  
Author(s):  
G. Low ◽  
L.M. Tho ◽  
E. Leen ◽  
E. Wiebe ◽  
S. Kakumanu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Operative Staging

scholarly journals Glove single-port laparoscopy-assisted transanal total mesorectal excision for low rectal cancer: a preliminary report

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Wanglin Li ◽  
Boye Dong ◽  
Baifu Peng ◽  
Jiabao Lu ◽  
Zixin Wu ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Hospital Stay ◽  
Single Port ◽  
Low Rectal Cancer ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Single Port Laparoscopy ◽  
The Mean

Abstract Purpose Glove single-port laparoscopy-assisted transanal total mesorectal excision (TaTME) has been successfully carried out in our medical center. The purpose of this study is to evaluate the feasibility of this emerging operation. Methods This technique was performed by self-made glove single-port laparoscopic platform to radically resect low rectal cancer. Short-term postoperative results, including complications, length of hospital stay, and follow-up results were collected and analyzed statistically. Results There are five consecutive patients (three males, two females) who underwent this surgery and included in this study. The mean distance from the tumor to the anal verge was 4.8 cm (range 4.0–6.0). The surgery was completed in all cases, and the rectal tumor was removed successfully without conversion; circumferential margins of all the excised specimens were negative. The mean time of operation was 338.00 min (range 280–400). The average number of lymph node dissection was 12.20. The average postoperative hospital stay was 8.60 days. During the follow-up (14.80 ± 1.92 months), all preventive ileostomies were successfully closed in about 3 months after the surgery, all patients had satisfactory anal function, and no tumor recurrence was found. Conclusion Glove single-port laparoscopy-assisted TaTME has a significant effect in specific patients with low rectal cancer, with rapid recovery and high safety. Prospective randomized studies involving more case counts and long-term follow-up results, especially oncologic outcomes, are needed to validate this technique.

scholarly journals Delta Radiomics Can Predict Distant Metastasis in Locally Advanced Rectal Cancer: The Challenge to Personalize the Cure

2020 ◽  
Vol 10 ◽  
Author(s):  
Giuditta Chiloiro ◽  
Pablo Rodriguez-Carnero ◽  
Jacopo Lenkowicz ◽  
Calogero Casà ◽  
Carlotta Masciocchi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Distant Metastasis ◽  
Confusion Matrix ◽  
External Validation ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Features Selection ◽  
Testing Data

PurposeDistant metastases are currently the main cause of treatment failure in locally advanced rectal cancer (LARC) patients. The aim of this research is to investigate a correlation between the variation of radiomics features using pre- and post-neoadjuvant chemoradiation (nCRT) magnetic resonance imaging (MRI) with 2 years distant metastasis (2yDM) rate in LARC patients.Methods and MaterialsDiagnostic pre- and post- nCRT MRI of LARC patients, treated in a single institution from May 2008 to June 2015 with an adequate follow-up time, were retrospectively collected. Gross tumor volumes (GTV) were contoured by an abdominal radiologist and blindly reviewed by a radiation oncologist expert in rectal cancer. The dataset was firstly randomly split into 90% training data, for features selection, and 10% testing data, for the validation. The final set of features after the selection was used to train 15 different classifiers using accuracy as target metric. The models’ performance was then assessed on the testing data and the best performing classifier was then selected, maximising the confusion matrix balanced accuracy (BA).ResultsData regarding 213 LARC patients (36% female, 64% male) were collected. Overall 2yDM was 17%. A total of 2,606 features extracted from the pre- and post- nCRT GTV were tested and 4 features were selected after features selection process. Among the 15 tested classifiers, logistic regression proved to be the best performing one with a testing set BA, sensitivity and specificity of 78.5%, 71.4% and 85.7%, respectively.ConclusionsThis study supports a possible role of delta radiomics in predicting following occurrence of distant metastasis. Further studies including a consistent external validation are needed to confirm these results and allows to translate radiomics model in clinical practice. Future integration with clinical and molecular data will be mandatory to fully personalized treatment and follow-up approaches.

The Contribution of Follow-Up Programs in the Reduction of Mortality of Rectal Cancer Recurrences

2001 ◽  
Vol 18 (5) ◽  
pp. 403-408 ◽  
Author(s):  
Vassilios A. Komborozos ◽  
George J. Skrekas ◽  
Christos A. Pissiotis
Keyword(s):  
Rectal Cancer ◽  
Reduction Of Mortality

Is follow-up CT imaging of the chest and abdomen necessary after preoperative neoadjuvant therapy in rectal cancer patients without evidence of metastatic disease at diagnosis?

2013 ◽  
Vol 15 (11) ◽  
pp. e654-e658 ◽  
Author(s):  
T. A. Jaffe ◽  
A. M. Neville ◽  
M. R. Bashir ◽  
H. E. Uronis ◽  
J. M. Thacker
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Ct Imaging
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