scholarly journals Three-year outcome after transanal versus laparoscopic total mesorectal excision in locally advanced rectal cancer: a multicenter comparative analysis

2020 ◽  
Author(s):  
F. Borja de Lacy ◽  
Sapho X. Roodbeen ◽  
Jose Ríos ◽  
Jacqueline van Laarhoven ◽  
Ana Otero-Piñeiro ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Locoregional Recurrence ◽  
Locally Advanced ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Advanced Rectal Cancer ◽  
Mesorectal Excision ◽  
Free Survival ◽  
Disease Free

Abstract Background For patients with mid and distal rectal cancer, robust evidence on long-term outcome and causal treatment effects of transanal total mesorectal excision (TaTME) is lacking. This multicentre retrospective cohort study aimed to assess whether TaTME reduces locoregional recurrence rate compared to laparoscopic total mesorectal excision (LapTME). Methods Consecutive patients with rectal cancer within 12 centimetres from the anal verge and clinical stage II-III were selected from three institutional databases. Outcome after TaTME (Nov 2011 - Feb 2018) was compared to a historical cohort of patients treated with LapTME (Jan 2000 - Feb 2018) using the inverse probability of treatment weights method. The primary endpoint was three-year locoregional recurrence. Results A total of 710 patients were analysed, 344 in the TaTME group and 366 in the LapTME group. At three years, cumulative locoregional recurrence rates were 3.6% (95% CI, 1.1–6.1) in the TaTME group and 9.6% (95% CI, 6.5–12.7) in the LapTME group (HR = 0.4; 95% CI, 0.23–0.69; p = 0.001). Three-year cumulative disease-free survival rates were 74.3% (95% CI, 68.8–79.8) and 68.6% (95% CI, 63.7–73.5) (HR = 0.82; 95% CI, 0.65–1.02; p = 0.078) and three-year overall survival 87.2% (95% CI, 82.7–91.7) and 82.2% (95% CI, 78.0-86.2) (HR = 0.74; 95% CI, 0.53–1.03; p = 0.077), respectively. In patients who underwent sphincter preservation procedures, TaTME was associated with a significantly better disease-free survival (HR = 0.78; 95% CI, 0.62–0.98; p = 0.033). Conclusions These findings suggest that TaTME may improve locoregional recurrence and disease-free survival rates among patients with mid and distal locally advanced rectal cancer.

LONG-TERM OUTCOMES OF TRANSANAL TOTAL MESORECTAL EXCISION FOR RECTAL CANCER

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
M Labalde Martínez ◽  
A Vivas Lopez ◽  
J Ocaña Jimenez ◽  
O García Villar ◽  
C Nevado García ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Overall Survival ◽  
Total Mesorectal Excision ◽  
Functional Outcomes ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Free Survival ◽  
Disease Free

Abstract INTRODUCTION Transanal total mesorectal excision (TaTME) for rectal cancer offers a better vision of the dissection planes and facilitates the distal transection of the rectum. The aim of this study was to compare functional outcomes, local recurrence rate y 2-years overall survival and disease free survival rates of TaTME and laparoscopic total mesorectal excision (LPC TME). MATERIAL AND METHODS From December 2016 to October 2018, 50 patients (36 males and 14 females) with low rectal cancer and an age of 67 (55.7-75.2) years underwent TME (20 TaTME and 30 LPCTME). RESULTS Clinical features and quality indicators for rectal cancer surgery were similar in both groups. After a median follow-up of 35 (30-40) months, low anterior resection syndrome rate was 14% (15% vs 13%, p = 0.043), fecal incontinence rate was 8% (15% vs 3%, p = 0.017) and sexual dysfunction was 8% (15% vs 3%, p = 0.017). Systemic recurrence rate was 10% (15% vs 6%, p = 0.377). One patient presented local recurrence 2 years after TATME. 2-years overall survival rate was 98% (95% vs 100%, p = 0.400) and 2-years disease free survival rate was 90 % (85% vs 93%, p = 0.377). CONCLUSION Although 2-years overall survival and disease free survival rates were similar in TaTME and LPC TME group, functional outcomes were worse after TATME in our study.

Intensification of neoadjuvant therapy in patients with locally advanced rectal cancer

2021 ◽  
Vol 11 (2) ◽  
pp. 19-28
Author(s):  
Z. Z. Mamedli ◽  
A. V. Polynovskiy ◽  
D. V. Kuzmichev ◽  
S. I. Tkachev ◽  
A. A. Aniskin
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Disease Free Survival ◽  
Complete Response ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Control Group ◽  
Free Survival ◽  
Disease Free

The aim of the study: to increase the frequency of achieving pathologic complete response and increase disease-free survival in the investigational group of patients with locally advanced rectal cancer T3(MRF+)–4N0–2M0 by developing a new strategy for neoadjuvant therapy.Materials and methods. In total, 414 patients were assigned to treatment. Control group I included 89 patients who underwent radiotherapy (RT) 52–56 Gy/26–28 fractions with concurrent capecitabine twice daily 5 days per week. Control group II included 160 patients who underwent RT 52–56 Gy/26–28 fractions with concurrent capecitabine twice daily 5 days per week and oxaliplatin once a week, during the course of RT. Study group III consisted of 165 patients. This group combined RT 52–56 Gy/26–28 fractions with concurrent capecitabine twice daily 5 days per week and additional consecutive CapOx cycles. This group was divided into 2 subgroups: subgroup IIIa included 106 patients with consolidating chemotherapy (after CRT); subgroup IIIb included 59 patients who underwent “sandwich” treatment. Therapy consisted of conducting from 1 to 2 cycles of induction CapOx (up to CRT) and from 1 to 2 cycles of consolidating CapOx with an interval of 7 days. In the interval between the courses of drug therapy, RT 52–56 Gy/26–28 fractions was performed. According to the results of the control examination, further treatment tactics were determined. The primary end points were 5-year disease-free survival and the achievement of a pathologic complete response.Results. Pathologic complete response was significantly more often recorded in patients in the investigational group III (17.48 %; p = 0.021) compared with control groups (7.95 % in the I group and 8.28 % in the II group). 5-year disease-free survival in patients in the study groups was: 71.5 % in the III group, 65.6 % in the II group and 56.9 % in the I group.Conclusion. The shift in emphasis on strengthening the neoadjuvant effect on the tumor and improving approaches to drug therapy regimens have significantly improved disease-free survival of patients with locally advanced rectal cancer.

scholarly journals Systematic Review: Adjuvant Chemotherapy for Locally Advanced Rectal Cancer with respect to Stage of Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-10
Author(s):  
Shahab Hajibandeh ◽  
Shahin Hajibandeh
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Stage Ii ◽  
Stage Iii ◽  
Free Survival ◽  
Disease Free

Background. Recent meta-analysis of 21 randomised controlled trials (RCTs) supports the use of adjuvant chemotherapy for nonmetastatic rectal carcinoma. In order to define a subgroup of patients who can potentially benefit from postoperative adjuvant chemotherapy, this study aims to review trials investigating adjuvant chemotherapy with respect to stage of disease in patients with locally advanced rectal cancer who had undergone surgery for cure (stage II and stage III). Methods. We searched electronic information sources to identify randomised trials evaluating adjuvant chemotherapy in patients with stages II and III rectal cancer with overall survival or disease-free survival as outcomes. Scottish Intercollegiate Guidelines Network notes on methodology were used to assess the methodological quality of the selected studies. Random-effects models were applied to calculate pooled outcome data. Results. Eight studies reporting total of 5527 patients were selected for analysis. Adjuvant chemotherapy was associated with statistically significant improvement in disease-free survival and overall survival compared to surgery alone in both stage II and stage III cancer. Conclusions. This study indicates that both stage II and stage III rectal cancer patients may benefit from postoperative adjuvant chemotherapy. However, the benefits of adjuvant chemotherapy for patients who already had neoadjuvant chemoradiation still remain unknown.

scholarly journals Identification of a DNA methylation signature to predict disease-free survival in locally advanced rectal cancer

Oncotarget ◽  
2014 ◽  
Vol 5 (18) ◽  
pp. 8123-8135 ◽  
Author(s):  
Jochen Gaedcke ◽  
Andreas Leha ◽  
Rainer Claus ◽  
Dieter Weichenhan ◽  
Klaus Jung ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Rectal Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Free Survival ◽  
Disease Free
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