A CASE OF LONG-TERM DISEASE-FREE SURVIVAL AFTER SPLENECTOMY FOR SPLENIC METASTASIS FROM RECTAL CANCER

3518 Background: Laparoscopic surgery for rectal cancer has been used widely. However, recent two randomized trials raised concerns about short-term oncologic safety of laparoscopic surgery for rectal cancer. The aim of this study was to evaluate the long-term oncologic safety of laparoscopic surgery for rectal cancer based on 7-year data from the Comparison of Open versus laparoscopic surgery for mid or low REctal cancer After Neoadjuvant chemoradiotherapy (COREAN) trial. Methods: COREAN trial was a non-inferiority, randomized controlled trial. Between April, 2006, and Aug, 2009, eligible participants with mid or low rectal cancer treated with preoperative chemoradiotherapy were randomly assigned (1:1) to laparoscopic (n = 170) or open surgery (n = 170). Seven-year outcomes included overall and disease-free survival, and local recurrence. Log-rank test and stratified Cox regression analysis were used for survival analysis. Analysis was by intention to treat. Results: The median follow-up times were 84 months (IQR: 61.5-97.0). No differences were found between laparoscopic and open surgery group in terms of overall and disease-free survival, and local recurrence (7-year overall survival: 83.2% [laparoscopic] vs 77.3% [open], p = 0.48; 7-year disease-free survival: 71.6% [laparoscopic] vs 64.3% [open], p = 0.20; 7-year local recurrence: 3.3% [laparoscopic] vs 7.9% [open], p = 0.08). Stratified Cox regression analysis adjusted for ypT, ypN and tumor regression grade showed no significant difference between groups in terms of overall and disease-free survival, and local recurrence. The hazard ratios for overall survival, disease-free survival and local recurrence (open vs laparoscopic surgery) were 0.96 (95% CI = 0.58-1.57), 1.03 (95% CI = 0.70-1.53), and 2.28 (95% CI = 0.82-7.16), respectively. Conclusions: The 7-year analysis confirm the long-term oncological safety of laparoscopic surgery for rectal cancer treated with preoperative chemoradiotherapy. The use of laparoscopic surgery does not compromise the long-term survival outcomes in rectal cancer. Clinical trial information: NCT00470951.

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A Case of Long-term Disease-free Survival after Radiotherapy for Locally Recurrent Rectal Cancer

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.66.416 ◽

2013 ◽

Vol 66 (6) ◽

pp. 416-421

Author(s):

Nobuyoshi Yamazaki ◽

Akihiro Kobayashi ◽

Yusuke Nishizawa ◽

Masaaki Ito ◽

Masanori Sugito ◽

...

Keyword(s):

Rectal Cancer ◽

Disease Free Survival ◽

Recurrent Rectal Cancer ◽

Free Survival ◽

Locally Recurrent Rectal Cancer ◽

Locally Recurrent ◽

Disease Free

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Letter to the editor: Not inferior but rather superior long-term disease-free survival after laparoscopic versus open total mesorectal excision for low and mid rectal cancer!

International Journal of Colorectal Disease ◽

10.1007/s00384-021-04087-2 ◽

2022 ◽

Author(s):

Andreas D. Rink

Keyword(s):

Rectal Cancer ◽

Total Mesorectal Excision ◽

Disease Free Survival ◽

Mesorectal Excision ◽

Free Survival ◽

Letter To The Editor ◽

Disease Free

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A Report of a Case Attained Long Term Disease Free Survival after Resection of Rectal Cancer with Ischial Metastasis

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.63.173 ◽

2010 ◽

Vol 63 (3) ◽

pp. 173-178

Author(s):

Hiroshi Iino ◽

Yoshiyuki Mori ◽

Fumihiko Mitsui ◽

Hideki Fujii

Keyword(s):

Rectal Cancer ◽

Disease Free Survival ◽

Free Survival ◽

Disease Free

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Single-Docking Full Robotic Surgery for Rectal Cancer: A Single-Center Experience

Surgical Innovation ◽

10.1177/1553350618765868 ◽

2018 ◽

Vol 25 (3) ◽

pp. 258-266 ◽

Cited By ~ 3

Author(s):

Sergio Alfieri ◽

Dario Di Miceli ◽

Roberta Menghi ◽

Caterina Cina ◽

Claudio Fiorillo ◽

...

Keyword(s):

Rectal Cancer ◽

Robotic Surgery ◽

Conversion Rate ◽

Disease Free Survival ◽

Perioperative Outcomes ◽

Free Survival ◽

Oncological Outcomes ◽

Anterior Rectal Resection ◽

Disease Free

Purpose. Robotic surgery has gradually gained importance in the treatment of rectal cancer. However, recent studies have not shown any advantages when compared with laparoscopy. The objective of this study is to report a single surgeon’s experience in robotic rectal surgery focusing on short-term and long-term outcomes. Methods. Sixty consecutive robotic rectal resections for adenocarcinoma, over a 4-year period, were retrospectively reviewed. Patients’ characteristics and perioperative outcomes were analyzed. Oncological outcomes and surgical resection quality as well as overall and disease-free survival were also assessed. Results. Thirty patients out of 60 (50%) underwent neoadjuvant therapy. Anterior rectal resection was performed in 52 cases (86.7%), and abdominoperineal resection was done in 8 cases (13.3%). Mean operative time was 283 (±68.6) minutes. The conversion rate was 5% (3 patients). Postoperative complications occurred in 10 cases (16.7%), and reoperation was required in 1 case (1.7%). Mean hospital stay was 9 days, while 30-day mortality was 1.7% (1 patients). The histopathological analysis reported a negative circumferential radial margin and distal margins in 100% of cases with a complete or near complete total mesorectal excision in 98.3% of patients. Mean follow-up was 32.8 months with a recurrence rate of 3.4% (2 patients). Overall survival and disease-free survival were 94% and 87%, respectively. Conclusions. Robotic surgery for rectal cancer proves to be safe and feasible when performed by highly skilled surgeons. It offers acceptable perioperative outcomes with a conversion rate notably lower than with the laparoscopic approach. Adequate pathological results and long-term oncological outcomes were also obtained.

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The Survival after Laparoscopic Versus Open Curative Excision for Rectal Cancer

Integrative Journal of Medical Sciences ◽

10.15342/ijms.7.175 ◽

2020 ◽

Vol 7 ◽

Author(s):

Turki Alshammari ◽

Sulaiman Alshammari ◽

Ali Alsaffar ◽

Riyadh Hakami ◽

Mohammed Alali ◽

...

Keyword(s):

Rectal Cancer ◽

Local Recurrence ◽

Disease Free Survival ◽

Research Centre ◽

Long Term Outcomes ◽

Free Survival ◽

Distal Recurrence ◽

Disease Free

Background: Management of rectal cancer has been evolved over the past two decades with the introduction of total mesorectal excision (TME) and laparoscopic resection. Objective: This study aims to assess the difference in the long term outcomes after laparoscopic and open resection for potentially curable, non-metastatic rectal cancer patients.Methods: This is a retrospective study which has been conducted in a single tertiary care center where the patients were recruited from the colorectal database of the Section of Colon and Rectal Surgery at King Faisal Specialist Hospital & Research Centre (KFSH&RC). It included all the patients who had non-metastatic rectal cancer and underwent laparoscopic or open curative resection regardless of their age or the comorbid status during the period from January 2012 – December 2015. We studied the long-term outcomes for those patients which included the completeness of resection of the tumor, overall 3-year survival, 3-year disease free survival, local recurrence and distal recurrence of the cancer.Results:120 patients were included in this study, 69 of them were males and 51 were females. 86 (71.7%) of them underwent open surgery while 34 (28.3%) underwent laparoscopic surgery. After a mean follow up of 32.4 months: 104 patients were alive, 7 deceased and 9 were lost of follow up. Local recurrence in the open approach (OA), and laparoscopic approach (LA) groups was 3/86 (3.5%) and 4/34 (11.8%) respectively. Distal recurrence occurred in 12/86 (14%) of OA and 5/34 (14.7%) of LA. Overall 3-years survival for OA and LA was 89% and 97% respectively and the 3-years disease free survival was 49% and 57% respectively.Conclusion: Laparoscopic and open rectal excision were similar in their outcome.

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