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Survival outcomes after isolated local recurrence of rectal cancer and risk analysis affecting its resectability

Authors
 Youn Young Park  ;  Jaeim Lee  ;  Yoon Dae Han  ;  Min Soo Cho  ;  Hyuk Hur  ;  Byung Soh Min  ;  Kang Young Lee  ;  Seong Taek Oh  ;  Nam Kyu Kim 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.122(7) : 1470-1480, 2020-12 
Journal Title
JOURNAL OF SURGICAL ONCOLOGY
ISSN
 0022-4790 
Issue Date
2020-12
MeSH
Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local / mortality* ; Quality of Life ; Rectal Neoplasms / mortality* ; Rectal Neoplasms / pathology ; Rectal Neoplasms / psychology ; Rectal Neoplasms / surgery ; Retrospective Studies
Keywords
local ; neoplasm recurrence ; prognosis ; rectal neoplasm
Abstract
Background and objectives: This study aimed to investigate the clinical course and prognostic factors after isolated local recurrence (iLR) and to identify the predictive factors for R0 resection of locally recurrent rectal cancer (LRRC).

Methods: We retrospectively reviewed the medical records of 76 patients with iLR who had undergone radical surgery for a primary tumor from 2003 to 2015.

Results: The iLR rate was 2.5%. From 76 patients, 39 patients underwent R0 resection for iLR. Multivariate analysis revealed that initial open surgery, neoadjuvant chemoradiation, and p/ypT ≥ 3 were poor prognostic factors after iLR as regard to the variables related to the primary tumor; and symptom presence at the time of iLR diagnosis, higher fixity, and no chemotherapy after iLR were associated with shorter overall survival after iLR, and R0 resection of LRRC was the only favorable prognostic factor for progression-free survival after iLR as regard to the variables related to LRRC. Higher tumor level, negative pathologic circumferential margin of the primary tumor, and low fixity of LRRC were favorable factors in achieving R0 resection of LRRC.

Conclusions: Early detection of iLR before symptom development, use of chemotherapy after iLR and R0 resection of LRRC should be considered to improve survival outcomes after iLR.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/jso.26161
DOI
10.1002/jso.26161
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Lee, Kang Young(이강영)
Cho, Min Soo(조민수)
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/181500
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