Annals of Coloproctology

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Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Epidemiology & etiology

Characteristics of Patients Presented With Metastases During or After Completion of Chemoradiation Therapy for Locally Advanced Rectal Cancer: A Case Series: Radwan Torky, Mohammed Alessa, Ho Seung Kim, Ahmed Sakr, Eman Zakarneh, Fozan Sauri, Heejin Bae, Nam Kyu Kim; Ann Coloproctol. 2021;37(3):186-191. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.10.1

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Purpose
Locally advanced rectal cancer (LARC) is managed by chemoradiotherapy (CRT), followed by surgery. Herein we reported patients with metastases during or after CRT.
Methods
Data of patients with LARC who received CRT from 2008 to 2017 were reviewed. Patients with metastases after CRT were included. Those with metastatic tumors at the initial diagnosis were excluded.
Results
Fourteen patients (1.3%) of 1,092 who received CRT presented with metastases. Magnetic resonance circumferential resection margin (mrCRM) and mesorectal lymph nodes (LNs) were positive in 12 patients (85.7%). Meanwhile, magnetic resonance extramural vascular invasion (mrEMVI) was positive in 10 patients (71.4%). Magnetic resonance tumor regression grade (mrTRG) 4 and mrTRG5 was detected in 5 and 1 patient respectively. Ten patients (71.4%) underwent combined surgery and 3 (21.4%) received palliative chemotherapy.
Conclusion
Patients with metastases after CRT showed a higher rate of positive mrCRM, mrEMVI, mesorectal LNs, and poor tumor response. Further studies with a large number of patients are necessary for better survival outcomes in LARC.

Citations

Citations to this article as recorded by

Clinical implications of radiologic criteria and prognostic factors for lateral lymph node metastasis in low rectal cancer
Gyung Mo Son
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Annals of Surgical Treatment and Research.2023; 105(6): 341. CrossRef
Advances in the Treatment of Colorectal Cancer with Peritoneal Metastases: A Focus on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Youngbae Jeon, Eun Jung Park
The Ewha Medical Journal.2023;[Epub] CrossRef
Recent Advance in the Surgical Treatment of Metastatic Colorectal Cancer-An English Version
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The Ewha Medical Journal.2022;[Epub] CrossRef

Pelvic Exenteration as the Treatment for Recurrent or Locally Advanced Rectal Cancer.: Song, Seong Kyu , Park, Yong Keun , Suh, Kwang Wook; J Korean Soc Coloproctol. 2005;21(5):314-319.

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Abstract PDF: PURPOSE
The purpose of this study is to evaluate the value of pelvic exenteration (PE) for recurrent or locally advanced rectal cancer.
METHODS
This retrospective study analyzed 20 patients who underwent PE for rectal cancer from June 1994 to October 2003 in Ajou University Hospital. The surgical severity, the postoperative complications, and the survival rate were analyed based on the medical records.
RESULTS
The mean operation time was 221.5+/-93.0 minutes, the mean blood loss 750.5+/-223.3 cc, and the mean transfusion amount RBC 6.5+/-4.3 units. Operative mortality was 5% (1/20). A bleeding-associated complication was noted in one patient who underwent a reoperation for hemostasis. Other minor complications were small bowel obstruction (n=3), abdominal wound infection (n=5), vesicocutaneous fistula (n=2), delayed healing of the perineal wound (n=10). The overall 5-year survival rate was 52.6% (10 of 19 patients, excluding the operative mortality case).
CONCLUSIONS
Our study showed acceptable surgical severity and postoperative complications and a favorable 5-year survival rate (> or =50%) for pelvic exenteration as a treatment for recurrent or locally advanced rectal cancer. With strictly selected patients, PE may be one of the treatment options for recurrent or locally advanced rectal cancer.

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