LATE RESULTS OF TOTAL MESORECTUMECTOMY IN RECTAL CANCER AFTER OPEN AND LAPAROSCOPIC PROCEDURES

AIM: to evaluate late results for patients that had open and laparoscopic total mesorectumectomy (TME) surgery for rectal cancer. PATIENTS AND METHODS: prospective cohort study included 103 patients aged from 20 to 70 years with rectal cancer. Patients were divided into 2 groups: the 1st group included 47 patients after laparoscopic TME (LTME) and the 2nd group included 56 patients after open one (OTME). All tumors were adenocarcinomas. Late results were assessed by actual and disease-free 3- and 5-year survival in 97 (94.2%) patients. RESULTS: local recurrence rate after OTME and LTME was 11,5% (6 patients) and 11,1% (5 patients) (p>0.05). Distant metastases occurred in 4 (7,7%) and 3 (6,7%) cases, respectively (p>0.05). The actual survival after LTME was 80.0% (81.8% after OTME, p>0.05), the disease-free 3-year survival rate was 56,7% (60.6% after OTME, p>0.05), 5-year survival was 31.6% (31.8% after OTME, p>0.05). CONCLUSION: no significant differences were found between laparoscopic and open approach for rectal cancer in local recurrence rate and survival.

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Local recurrence rate in rectal cancer patients with distal resection margin less than 9 mm

European Journal of Cancer ◽

10.1016/s0959-8049(01)81619-1 ◽

2001 ◽

Vol 37 ◽

pp. S305

Author(s):

E. Leo ◽

S. Andreola ◽

F. Belli ◽

G. Bonfanti ◽

G. Gallino ◽

...

Keyword(s):

Rectal Cancer ◽

Local Recurrence ◽

Cancer Patients ◽

Recurrence Rate ◽

Local Recurrence Rate ◽

Resection Margin ◽

Distal Resection Margin

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Influence of surgery on metachronous distant metastases and survival in rectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.1.324 ◽

1998 ◽

Vol 16 (1) ◽

pp. 324-329 ◽

Cited By ~ 110

Author(s):

F Köckerling ◽

M A Reymond ◽

A Altendorf-Hofmann ◽

O Dworak ◽

W Hohenberger

Keyword(s):

Rectal Cancer ◽

Survival Rate ◽

Local Recurrence ◽

Recurrence Rate ◽

Local Recurrence Rate ◽

Scientific Evidence ◽

Distant Metastases ◽

Outcome Criterion ◽

Quality Of Surgery

PURPOSE Total mesorectal excision (TME) and other technical surgical factors reduce local recurrence rate in rectal cancer. Scientific evidence of the positive effect of optimal surgery on survival is locking. Whether a reduction in the incidence of distant metastases can be achieved with optimal surgery is uncertain. We examine the effects of the quality of surgery, as reflected by local recurrence rate, on survival and the incidence of initial distant metastases. PATIENTS AND METHODS Between 1974 and 1991, 1,581 consecutive patients who underwent curative resection (RO) for rectal carcinoma were monitored for recurrence and survival. TME was introduced in 1985. No patient received adjuvant radiotherapy or chemotherapy. The median follow-up time was greater than 13 years. RESULTS The local recurrence rate decreased from 39.4% to 9.8% during the study period (P < .0001). The observed 5-year survival rate improved from 50% to 71% (P < .0001). Three hundred six patients with local recurrence had a significantly lower observed 5-year survival rate (P < .0001). A total of 1,285 patients had no local recurrence, but 275 of them developed distant metastases (International Union Against Cancer [UICC] stage I, 8%; stage II, 16%; stage III, 40%). Better-quality surgery had no effect on the incidence of initial distant metastases, which remained constant (P = .44). CONCLUSION Quality of surgery is an independent prognostic factor for survival in rectal cancer, but has no influence on initial occurrence of distant metastases. Local recurrence cannot be considered an outcome criterion of adjuvant treatment without consideration of the surgeon as a risk factor.

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305 POSTER Preoperative core needle biopsy does not increase local recurrence rate in breast cancer patients

European Journal of Surgical Oncology ◽

10.1016/s0748-7983(06)70740-5 ◽

2006 ◽

Vol 32 ◽

pp. S92

Author(s):

F. Fitzal ◽

E. Sporn ◽

W. Draxler ◽

M. Mittlböck ◽

O. Riedl ◽

...

Keyword(s):

Breast Cancer ◽

Local Recurrence ◽

Cancer Patients ◽

Recurrence Rate ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Local Recurrence Rate ◽

Breast Cancer Patients ◽

Core Needle

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ISR for T1-2 Low Rectal Cancer: A Japanese Approach

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0040-1714240 ◽

2020 ◽

Vol 33 (06) ◽

pp. 361-365

Author(s):

Masaaki Ito

Keyword(s):

Rectal Cancer ◽

Local Recurrence ◽

Recurrence Rate ◽

Phase Ii ◽

Local Recurrence Rate ◽

Anal Verge ◽

Low Rectal Cancer ◽

Rectal Cancer Surgery ◽

Rectal Cancers ◽

Anal Preservation

AbstractThe evolution over the past 20 years of anal preservation in rectal cancer surgery has been truly remarkable. Intersphincteric resection (ISR) reported by Schiessel in 1994 in Australia has been shown to enable anal preservation even for cancers quite close to the anus. In Japan, ISR via the detachment of the anal canal between the internal and external sphincters and excision of the internal sphincter first began to be practiced in the latter half of 1990. A multicenter Phase II trial of ISR in Japan suggested that 70% of the cases had relatively good function with less than 10 points of Wexner score but around 10% had severe incontinence that would not be improved for long term. The primary end point of the clinical study, 3-year local recurrence rate, was 13.2% across the overall cohort (T1, 0%; T2, 6.9%; and T3, 21.6%). When ISR is performed on T1/T2 rectal cancers, sufficient circumferential resection margin can be obtained even without preoperative chemoradiotherapy, and local recurrence rate was acceptably low. Based on these evidences, ISR is a currently important, standard treatment option among anal-preserving surgeries for T1/T2 low-lying rectal cancers. In Japan, a feasibility study (LapRC trial) of laparoscopic ISR on Stage 0 and Stage 1 low rectal cancer showed excellent outcomes. A prospective Phase II clinical trial targeting low rectal cancers within 5 cm from the anal verge (ultimate trial) is being performed and awaiting the results in near future.

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