scholarly journals Prognostic Factors for Post-Recurrence Survival in Stage II and III Colorectal Carcinoma Patients

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1108
Author(s):  
Neda Nikolic ◽  
Davorin Radosavljevic ◽  
Dusica Gavrilovic ◽  
Vladimir Nikolic ◽  
Nemanja Stanic ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Advanced Colorectal Cancer ◽  
Locally Advanced ◽  
Disease Recurrence ◽  
Stage Ii ◽  
Stage Iii ◽  
Locally Advanced Colorectal Cancer ◽  
Stage Ii Colorectal Cancer

Background and objectives: This study aimed to evaluate prognostic factors for post-recurrence survival in local and locally advanced colorectal cancer patients. Materials and Methods: A total of 273 patients with stage III and high-risk stage II colorectal cancer were prospectively enrolled. All patients underwent operative treatment of the primary tumor and adjuvant fluorouracil-based chemotherapy. Results: Over the three-year period (2008–2010), a cohort of 273 patients with stage III and high-risk stage II colorectal cancer had been screened. During follow up, 105 (38.5%) patients had disease recurrence. Survival rates 1-, 3- and 5-year after recurrence were 53.9, 18.2 and 6.5%, respectively, and the median post-recurrence survival time was 13 months. Survival analysis showed that age at diagnosis (p < 0.01), gender (p < 0.05), elevated postoperative Ca19-9 (p < 0.01), tumor histology (adenocarcinoma vs. mucinous vs. signet ring tumors, p < 0.01) and tumor stage (II vs. III, p < 0.05) had a significant influence on post-recurrence survival. Recurrence interval and metastatic site were not related to survival following recurrence. Multivariate analysis showed that older age (HR 2.43), mucinous tumors (HR 1.51) and tumors expressing Ca19-9 at baseline (HR 3.51) were independently associated with survival following recurrence. Conclusions: Baseline patient and tumor characteristics largely predicted patient outcomes after disease recurrence. Recurrence intervals in local and locally advanced colorectal cancer were not found to be prognostic factors for post-recurrence survival. Older age, male gender, stage III and mucinous histology were poor prognostic factors after the disease had recurred. Stage II patients had remarkable post-recurrence survival compared to stage III patients.

Locally advanced colorectal cancer: Is a second look surgery and prophylactic HIPEC warranted?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15056-e15056 ◽  
Author(s):  
Rahul Bhamre ◽  
Jay Rashmi Anam ◽  
Manish Bhandare ◽  
Avanish Saklani
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
High Risk ◽  
Advanced Colorectal Cancer ◽  
Locally Advanced ◽  
Peritoneal Recurrence ◽  
High Risk Factors ◽  
Second Look ◽  
Locally Advanced Colorectal Cancer

e15056 Background: Peritoneal recurrence/carcinomatosis (PC) after curative surgery for colorectal cancer is the second most common site of recurrence and carries a poor prognosis. PC present relatively in the later stage, are difficult to detect by conventional imaging on follow up, and have limited options to treat after diagnosis. Second look surgery is the only definite option to diagnose early PC and presents an opportunity for disease control by cytoreductive surgery (CRS) and HIPEC. Multiple studies have attempted to identify clinico-pathological risk factors that predict high chances of PC. Our aim is to analyze the recurrence patterns and survival in locally advanced colorectal cancer, in an attempt to identify high risk factors for PC, which can be used as an indication for second look surgery and prophylactic HIPEC in such cases. Methods: Retrospective analysis of a prospectively maintained data of all colorectal cancer patients presenting to a tertiary cancer care referral center in India, from May 2010 to October 2015 was done. All patients who underwent surgery with curative intent and were clinico-pathological stage T4 and/or N2 M0 were included in the analysis. Results: 182 patients underwent curative resection with a clinico-pathological staging of T4 and/or N2 M0. There were 71 recurrences, out of which 30 (42.2%) were peritoneal, 7 (9.9%) were hepatic only while 34 (47.9 %) were non-hepatic systemic or multiple site. For a median follow up of 26 months, the estimated 3 year OS was 78 % while the 3 year DFS was 50.4 %. The median time to diagnosis of peritoneal recurrence was 13 months (4.7 – 55.7). The 3-year OS for patients with peritoneal recurrence was 48.6 % as against 57 % for liver only recurrence and 59.9 % for non liver systemic and multiple site recurrence, with a trend towards poorer survival for peritoneal recurrences, although non-significant (p – 0.377). Conclusions: Locally advanced colorectal cancer has a high risk of peritoneal recurrence which negatively impacts the survival. Well-designed RCTs need to be conducted to identify the high risk factors for PC and whether second look surgery and prophylactic HIPEC in such patients will improve survival with acceptable morbidity and mortality.

scholarly journals Locally advanced colorectal cancer: results of surgical treatment and prognostic factors

2011 ◽  
Vol 48 (4) ◽  
pp. 270-275 ◽  
Author(s):  
Fábio Guilherme Campos ◽  
Maria Célia Calijuri-Hamra ◽  
Antonio Rocco Imperiale ◽  
Desidério Roberto Kiss ◽  
Sergio Carlos Nahas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Advanced Colorectal Cancer ◽  
Locally Advanced ◽  
Survival Rates ◽  
Recurrence Rates ◽  
Free Survival ◽  
Histological Data ◽  
Locally Advanced Colorectal Cancer ◽  
Colorectal Cancer Patients

OBJECTIVES: To evaluate the incidence surgical results and prognostic factors of locally advanced colorectal cancer. METHODS: Cohort study including 679 colorectal cancer patients treated from 1997 to 2007. Clinical, surgical and histological data were analyzed. RESULTS: Ninety patients (females 61%; median age 59 years) were treated for locally advanced carcinomas (13.2%), either in the colon (66%) or rectum (34%). Extended resections most commonly involved the small bowel (19.8%), bladder (16.4%), uterus (12.9%) and ovaries (11.2%). Postoperative morbidity and mortality occurred in 23 (25.6%) and 3 (3.3%) patients, respectively. Survival and recurrence analysis among 76 R0 (84.4%) procedures revealed a 60% 5-year survival and 34% local recurrence rates. Survival curves demonstrated reduced rates for rectal location (45% vs 65%), tumor depth (50% for T4 vs 75% for T3), vascular/ lymphatic/perineural invasion (35% vs 80%) and lymph node metastasis (35% vs 80%). CONCLUSIONS: Locally advanced carcinomas were found in 13.2% of patients. Survival rates were negatively affected by rectal location and adverse histological features. Number of involved organs and neoplastic adhesions did not influenced chances of survival. A radical R0 extended resection was achieved in a high proportion of cases, resulting in a 60% cancer-free survival under acceptable operative risks.

EXPERIENCE OF THE APPLICATION OF THERMOCHEMIORRADIOTHERAPY IN COMBINED TREATMENT OF DYSTAL CANCER OF DIRECT INTESTINE

2019 ◽  
Vol 65 (1) ◽  
pp. 131-134
Author(s):  
Zhanna Startseva ◽  
Sergey Afanasev ◽  
Dina Plaskeeva
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Primary Tumor ◽  
Advanced Colorectal Cancer ◽  
Combined Treatment ◽  
Locally Advanced ◽  
Chemoradiation Therapy ◽  
Locally Advanced Colorectal Cancer

The article describes the experience of using ther-mochioradiotherapy in the combined treatment of distal locally advanced colorectal cancer, as well as comparing the effectiveness of treatment with chemoradiation therapy. The use of the proposed method as a component of the combined treatment of patients with rectal cancer allowed to increase the percentage of organ-preserving operations. As a result of thermochemotherapy, the prevalence of the primary tumor was significantly reduced, as a result of which the number of sphincter-bearing operations was reduced by almost 2 times (p

The efficacy of adjuvant chemotherapy for resected high-risk stage II and stage III colorectal cancer in frail patients

2021 ◽  
Author(s):  
Kosuke Mima ◽  
Nobutomo Miyanari ◽  
Keisuke Kosumi ◽  
Takuya Tajiri ◽  
Kosuke Kanemitsu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Stage Iii ◽  
Frail Patients
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