Prognostic factors associated with locally recurrent rectal cancer following primary surgery (Review)

  • Authors:
    • Yantao Cai
    • Zhenyang Li
    • Xiaodong Gu
    • Yantian Fang
    • Jianbin Xiang
    • Zongyou Chen
  • View Affiliations

  • Published online on: October 23, 2013     https://doi.org/10.3892/ol.2013.1640
  • Pages: 10-16
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

Locally recurrent rectal cancer (LRRC) is defined as an intrapelvic recurrence following a primary rectal cancer resection, with or without distal metastasis. The treatment of LRRC remains a clinical challenge. LRRC has been regarded as an incurable disease state leading to a poor quality of life and a limited survival time. However, curative reoperations have proved beneficial for treating LRRC. A complete resection of recurrent tumors (R0 resection) allows the treatment to be curative rather than palliative, which is a milestone in medicine. In LRRC cases, the difficulty of achieving an R0 resection is associated with the post‑operative prognosis and is affected by several clinical factors, including the staging of the local recurrence (LR), accompanying symptoms, patterns of tumors and combined therapy. The risk factors following primary surgery that lead to an increased rate of LR are summarized in this study, including the surgical, pathological and therapeutic factors.

References

1 

Phillips RK, Hittinger R, Blesovsky L, et al: Local recurrence following ‘curative’ surgery for large bowel cancer: II. The rectum and rectosigmoid. Br J Surg. 71:17–20. 1984.

2 

Faerden AE, Naimy N, Wiik P, et al: Total mesorectal excision for rectal cancer: difference in outcome for low and high rectal cancer. Dis Colon Rectum. 48:2224–2231. 2005. View Article : Google Scholar : PubMed/NCBI

3 

Enríquez-Navascués JM, Borda N, Lizerazu A, et al: Patterns of local recurrence in rectal cancer after a multidisciplinary approach. World J Gastroenterol. 17:1674–1684. 2011.PubMed/NCBI

4 

Jatzko GR, Jagoditsch M, Lisborg PH, et al: Long-term results of radical surgery for rectal cancer: multivariate analysis of prognostic factors influencing survival and local recurrence. Eur J Surg Oncol. 25:284–291. 1999. View Article : Google Scholar

5 

Yuan HY, Li Y, Yang GL, et al: Study on the causes of local recurrence of rectal cancer after curative resection: analysis of 213 cases. World J Gastroenterol. 4:527–529. 1998.PubMed/NCBI

6 

Chen ZH, Song XM, Chen SC, et al: Risk factors for adverse outcome in low rectal cancer. World J Gastroenterol. 18:64–69. 2012. View Article : Google Scholar : PubMed/NCBI

7 

Mathis KL, Larson DW, Dozois EJ, et al: Outcomes following surgery without radiotherapy for rectal cancer. Br J Surg. 99:137–143. 2012. View Article : Google Scholar : PubMed/NCBI

8 

Yang Z, Xu H, Zhang W, et al: A retrospective analysis of ultralow anterior resection vs. abdomino-perineal resection for lower rectal cancer. Hepatogastroenterology. 59:1780–1783. 2012.PubMed/NCBI

9 

Martin ST, Heneghan HM and Winter DC: Systematic review of outcomes after intersphincteric resection for low rectal cancer. Br J Surg. 99:603–612. 2012. View Article : Google Scholar : PubMed/NCBI

10 

Boras Z, Kondza G, Sisljagić V, et al: Prognostic factors of local recurrence and survival after curative rectal cancer surgery: a single institution experience. Coll Antropol. 36:1355–1361. 2012.

11 

Bülow S, Christensen IJ, Iversen LH and Harling H; Danish Colorectal Cancer Group. Intra-operative perforation is an important predictor of local recurrence and impaired survival after abdominoperineal resection for rectal cancer. Colorectal Dis. 13:1256–1264. 2011.

12 

Eriksen MT, Wibe A, Syse A, et al; Norwegian Rectal Cancer Group; Norwegian Gastrointestinal Cancer Group. Inadvertent perforation during rectal cancer resection in Norway. Br J Surg. 91:210–216. 2004. View Article : Google Scholar

13 

Compton CC: Pathologic prognostic factors in the recurrence of rectal cancer. Clin Colorectal Cancer. 2:149–160. 2002. View Article : Google Scholar : PubMed/NCBI

14 

Koca D, Binicier C, Oztop I, et al: Prognostic factors affecting recurrence and survival in patients with locally advanced rectal cancer. J BUON. 17:291–298. 2012.PubMed/NCBI

15 

Dresen RC, Peters EE, Rutten HJ, et al: Local recurrence in rectal cancer can be predicted by histopathological factors. Eur J Surg Oncol. 35:1071–1077. 2009. View Article : Google Scholar

16 

Parfitt JR and Driman DK: The total mesorectal excision specimen for rectal cancer: a review of its pathological assessment. J Clin Pathol. 60:849–855. 2007. View Article : Google Scholar

17 

Kuru B, Camlibel M, Dinç S, et al: Prognostic factors affecting local recurrence and survival for operable rectal cancers. J Exp Clin Cancer Res. 21:329–335. 2002.PubMed/NCBI

18 

Yun HR, Lee LJ, Park JH, et al: Local recurrence after curative resection in patients with colon and rectal cancers. Int J Colorectal Dis. 23:1081–1087. 2008. View Article : Google Scholar : PubMed/NCBI

19 

Lee JH, Jang HS, Kim JG, et al: Lymphovascular invasion is a significant prognosticator in rectal cancer patients who receive preoperative chemoradiotherapy followed by total mesorectal excision. Ann Surg Oncol. 19:1213–1221. 2012. View Article : Google Scholar

20 

Heald RJ and Ryall RD: Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1:1479–1482. 1986. View Article : Google Scholar : PubMed/NCBI

21 

Gosens MJ, Klaassen RA, Tan-Go I, et al: Circumferential margin involvement is the crucial prognostic factor after multimodality treatment in patients with locally advanced rectal carcinoma. Clin Cancer Res. 13:6617–6623. 2007. View Article : Google Scholar

22 

Wang C, Zhou ZG, Wang Z, Li L, Zheng YC, Zhao GP, Chen DY and Liu WP: Mesorectal spread and micrometastasis of rectal cancer studied with large slice technique and tissue microarray. J Surg Oncol. 91:167–172. 2005. View Article : Google Scholar

23 

Hansen MH, Balteskard L, Dørum LM, et al; Norwegian Colorectal Cancer Group. Locally recurrent rectal cancer in Norway. Br J Surg. 96:1176–1182. 2009. View Article : Google Scholar : PubMed/NCBI

24 

Nagtegaal ID and Quirke P: What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol. 26:303–312. 2008. View Article : Google Scholar : PubMed/NCBI

25 

Bernstein TE, Endreseth BH, Romundstad P and Wibe A; Norwegian Colorectal Cancer Group. Circumferential resection margin as a prognostic factor in rectal cancer. Br J Surg. 96:1348–1357. 2009. View Article : Google Scholar : PubMed/NCBI

26 

Pacelli F, Sanchez AM, Covino M, et al: Improved outcomes for rectal cancer in the era of preoperative chemoradiation and tailored mesorectal excision: a series of 338 consecutive cases. Am Surg. 79:151–161. 2013.

27 

Fitzgerald TL, Biswas T, O’Brien K, et al: Neoadjuvant radiotherapy for rectal cancer: adherence to evidence-based guidelines in clinical practice. World J Surg. 37:639–645. 2013. View Article : Google Scholar : PubMed/NCBI

28 

Kang J, Kim H, Hur H, et al: Circumferential resection margin involvement in stage III rectal cancer patients treated with curative resection followed by chemoradiotherapy: A surrogate marker for local recurrence? Yonsei Med J. 54:131–138. 2013. View Article : Google Scholar

29 

Leite JS, Martins SC, Oliveira J, et al: Clinical significance of macroscopic completeness of mesorectal resection in rectal cancer. Colorectal Dis. 13:381–386. 2011. View Article : Google Scholar : PubMed/NCBI

30 

Rutkowski A, Nowacki MP, Chwalinski M, et al: Acceptance of a 5-mm distal bowel resection margin for rectal cancer: is it safe? Colorectal Dis. 14:71–78. 2012. View Article : Google Scholar : PubMed/NCBI

31 

Park JH, Kim HC, Cho YK, et al: Narrow distal resection margin may be sufficient for rectal cancer after chemoradiation. Hepatogastroenterology. 58:769–774. 2011.

32 

Kwak JY, Kim CW, Lim SB, et al: Oncologically safe distal resection margins in rectal cancer patients treated with chemoradiotherapy. J Gastrointest Surg. 16:1947–1954. 2012. View Article : Google Scholar : PubMed/NCBI

33 

Bujko K, Rutkowski A, Chang GJ, et al: Is the 1-cm rule of distal bowel resection margin in rectal cancer based on clinical evidence? A systematic review. Ann Surg Oncol. 19:801–808. 2012. View Article : Google Scholar

34 

Young JR, Chang HK, Hun JK, et al: Clinical significance of serial serum carcinoembryonic antigen values for treating rectal cancer with preoperative chemoradiotherapy. J Korean Soc Coloproctol. 28:205–212. 2012. View Article : Google Scholar

35 

Lin JK, Lin CC, Yang SH, et al: Early postoperative CEA level is a better prognostic indicator than is preoperative CEA level in predicting prognosis of patients with curable colorectal cancer. Int J Colorectal Dis. 26:1135–1141. 2011. View Article : Google Scholar

36 

Glimelius B, Grönberg H, Järhult J, et al: A systematic overview of radiation therapy effects in rectal cancer. Acta Oncol. 42:476–492. 2003. View Article : Google Scholar : PubMed/NCBI

37 

Fleming FJ, Påhlman L and Monson JR: Neoadjuvant therapy in rectal cancer. Dis Colon Rectum. 54:901–912. 2011. View Article : Google Scholar : PubMed/NCBI

38 

Braendengen M, Tveit KM, Berglund A, et al: Randomized phase III study comparing preoperative radiotherapy with chemoradiotherapy in nonresectable rectal cancer. J Clin Oncol. 26:3687–3694. 2008. View Article : Google Scholar

39 

Kusters M, Valentini V, Calvo A, et al: Results of European pooled analysis of IORT-containing multimodality treatment for locally advanced rectal cancer: adjuvant chemotherapy prevents local recurrence rather than distant metastases. Ann Oncol. 21:1279–1284. 2010. View Article : Google Scholar

40 

Wanebo HJ, Koness RJ, Vezeridis MP, et al: Pelvic resection of recurrent rectal cancer. Ann Surg. 220:586–597. 1994. View Article : Google Scholar : PubMed/NCBI

41 

Reerink O, Mulder NH, Botke G, et al: Treatment of locally recurrent rectal cancer, results and prognostic factors. Eur J Surg Oncol. 30:954–958. 2004. View Article : Google Scholar : PubMed/NCBI

42 

Wanebo HJ, Antoniuk P, Koness RJ, et al: Pelvic resection of recurrent rectal cancer: technical considerations and outcomes. Dis Colon Rectum. 42:1438–1448. 1999. View Article : Google Scholar : PubMed/NCBI

43 

Suzuki K, Dozois RR, Devine RM, et al: Curative reoperations for locally recurrent rectal cancer. Dis Colon Rectum. 39:730–736. 1996. View Article : Google Scholar : PubMed/NCBI

44 

Hahnloser D, Nelson H, Gunderson LL, et al: Curative potential of multimodality therapy for locally recurrent rectal cancer. Ann Surg. 237:502–508. 2003. View Article : Google Scholar : PubMed/NCBI

45 

Pergolizzi S, Settineri N, Santacaterina A, et al: Prognostic factors in ambulatory patients with inoperable locoregionally recurrent rectal cancer following curative surgery. Anticancer Res. 19:1383–1390. 1999.

46 

Uemura M, Ikeda M, Noura S, et al: The features of late local recurrences following curative surgery for rectal cancer. Hepatogastroenterology. 59:1800–1803. 2012.PubMed/NCBI

47 

Caricato M, Borzomati D, Ausania F, et al: Prognostic factors after surgery for locally recurrent rectal cancer: an overview. Eur J Surg Oncol. 32:126–132. 2006. View Article : Google Scholar : PubMed/NCBI

48 

Asoglu O, Karanlik H, Muslumanoglu M, et al: Prognostic and predictive factors after surgical treatment for locally recurrent rectal cancer: a single institute experience. Eur J Surg Oncol. 33:1199–1206. 2007. View Article : Google Scholar

49 

Pacelli F, Tortorelli AP, Rosa F, et al: Locally recurrent rectal cancer: prognostic factors and long-term outcomes of multimodal therapy. Ann Surg Oncol. 17:152–162. 2010. View Article : Google Scholar : PubMed/NCBI

50 

Jiang Y, Wan YL, Liu YC, et al: Surgical outcomes for 187 patients with locally recurrent rectal cancer and analysis of prognostic factors. Zhonghua Wei Chang Wai Ke Za Zhi. 14:582–585. 2011.(In Chinese).

51 

Rahbari NN, Ulrich AB, Bruckner T, et al: Surgery for locally recurrent rectal cancer in the era of total mesorectal excision: is there still a chance for cure? Ann Surg. 253:522–533. 2011. View Article : Google Scholar

52 

Heriot AG, Byrne CM, Lee P, et al: Extended radical resection: the choice for locally recurrent rectal cancer. Dis Colon Rectum. 51:284–291. 2008. View Article : Google Scholar

53 

Harji DP, Sagar PM, Boyle K, et al: Outcome of surgical resection of second-time locally recurrent rectal cancer. Br J Surg. 100:403–409. 2013. View Article : Google Scholar

54 

Wiig JN, Larsen SG, Dueland S, et al: Salvage surgery for locally recurrent rectal cancer: total mesorectal excision during the primary operation does not influence the outcome. Colorectal Dis. 13:506–511. 2011. View Article : Google Scholar

55 

Wiig JN, Wolff PA, Tveit KM and Giercksky KE: Location of pelvic recurrence after ‘curative’ low anterior resection for rectal cancer. Eur J Surg Oncol. 25:590–594. 1999.

56 

Moore HG, Shoup M, Riedel E, et al: Colorectal cancer pelvic recurrences: determinants of resectability. Dis Colon Rectum. 47:1599–1606. 2004. View Article : Google Scholar : PubMed/NCBI

57 

Kusters M, Dresen RC, Martijin H, et al: Radicality of resection and survival after multimodality treatment is influenced by subsite of locally recurrent rectal cancer. Int J Radiat Oncol Biol Phys. 75:1444–1449. 2009. View Article : Google Scholar

58 

Yamada K, Ishizawa T, Niwa K, et al: Patterns of pelvic invasion are prognostic in the treatment of locally recurrent rectal cancer. Br J Surg. 88:988–993. 2001. View Article : Google Scholar : PubMed/NCBI

59 

Dozois EJ, Privitera A, Holubar SD, et al: High sacrectomy for locally recurrent rectal cancer: Can long-term survival be achieved? J Surg Oncol. 103:105–109. 2011. View Article : Google Scholar

60 

Kido A, Koyama F, Akahane M, et al: Extent and contraindications for sacral amputation in patients with recurrent rectal cancer: a systematic literature review. J Orthop Sci. 16:286–290. 2011. View Article : Google Scholar : PubMed/NCBI

61 

Hugate RR Jr, Dickey ID, Phimolsarnti R, et al: Mechanical effects of partial sacrectomy: when is reconstruction necessary? Clin Orthop Relat Res. 450:82–88. 2006. View Article : Google Scholar

62 

Davidge KM, Eskicioglu C, Lipa J, et al: Qualitative assessment of patient experiences following sacrectomy. J Surg Oncol. 101:447–450. 2010.PubMed/NCBI

63 

Cheng L, Yu Y, Zhu R, et al: Structural stability of different reconstruction techniques following total sacrectomy: a biomechanical study. Clin Biomech (Bristol, Avon). 26:977–981. 2011. View Article : Google Scholar

64 

Dassanayake BK, Samita S, Deen RY, et al: Local recurrence of rectal cancer in patients not receiving neoadjuvant therapy - the importance of resection margins. Ceylon Med J. 56:159–161. 2011. View Article : Google Scholar

65 

Ceyhan GO, Liebl F, Maak M, et al: The severity of neural invasion is a crucial prognostic factor in rectal cancer independent of neoadjuvant radiochemotherapy. Ann Surg. 252:797–804. 2010. View Article : Google Scholar

66 

Bae SH, Park W, Choi DH, et al: Palliative radiotherapy in patients with a symptomatic pelvic mass of metastatic colorectal cancer. Radiat Oncol. 6:522011. View Article : Google Scholar : PubMed/NCBI

67 

Mannaerts GH, Martijin H, Crommelin MA, et al: Feasibility and first results of multimodality treatment, combining EBRT, extensive surgery, and IOERT in locally advanced primary rectal cancer. Int J Radiat Oncol Biol Phys. 47:425–433. 2000. View Article : Google Scholar

68 

Hashiguchi Y, Sekine T, Sakamoto H, et al: Intraoperative irradiation after surgery for locally recurrent rectal cancer. Dis Colon Rectum. 42:886–893. 1999. View Article : Google Scholar : PubMed/NCBI

69 

Guo S, Reddy CA, Kolar M, et al: Intraoperative radiation therapy with the photon radiosurgery system in locally advanced and recurrent rectal cancer: retrospective review of the Cleveland clinic experience. Radiat Oncol. 7:1102012. View Article : Google Scholar

70 

Gunderson LL, Nelson H, Martenson JA, et al: Intraoperative electron and external beam irradiation with or without 5-fluorouracil and maximum surgical resection for previously unirradiated, locally recurrent colorectal cancer. Dis Colon Rectum. 39:1379–1395. 1996. View Article : Google Scholar

71 

Dresen RC, Gosens MJ, Martijn H, et al: Radical resection after IORT-containing multimodality treatment is the most important determinant for outcome in patients treated for locally recurrent rectal cancer. Ann Surg Oncol. 15:1937–1947. 2008. View Article : Google Scholar

Related Articles

Journal Cover

January 2014
Volume 7 Issue 1

Print ISSN: 1792-1074
Online ISSN:1792-1082

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Cai, Y., Li, Z., Gu, X., Fang, Y., Xiang, J., & Chen, Z. (2014). Prognostic factors associated with locally recurrent rectal cancer following primary surgery (Review). Oncology Letters, 7, 10-16. https://doi.org/10.3892/ol.2013.1640
MLA
Cai, Y., Li, Z., Gu, X., Fang, Y., Xiang, J., Chen, Z."Prognostic factors associated with locally recurrent rectal cancer following primary surgery (Review)". Oncology Letters 7.1 (2014): 10-16.
Chicago
Cai, Y., Li, Z., Gu, X., Fang, Y., Xiang, J., Chen, Z."Prognostic factors associated with locally recurrent rectal cancer following primary surgery (Review)". Oncology Letters 7, no. 1 (2014): 10-16. https://doi.org/10.3892/ol.2013.1640