Risk Factors of Rectal Cancer Local Recurrence: Population-based Survey and Validation of the Swedish Rectal Cancer Registry.
(2010) In Colorectal Disease 12. p.977-986- Abstract
- Aim Despite advances in rectal cancer treatment local recurrence (LR) remains a significant problem. To select high-risk patients for different treatment options aimed at reducing LR, it is essential to identify LR risk factors. Method LR and survival rates of 4157 patients registered 1995-1997 in the Swedish Rectal Cancer Registry were analysed. LR risk factors were analysed by multivariate methods. For LR patients the registry was validated and additional data retrieved. Results The five-year overall and cancer specific survival rates were 45% and 62%. LR was registered in 326 (8%) patients. After R0-resections for tumours in TNM-stages I-III, LR developed in 10% of tumours at 0-5 cm, 8% at 6-10 cm, and 6% at 11-15 cm above the anal... (More)
- Aim Despite advances in rectal cancer treatment local recurrence (LR) remains a significant problem. To select high-risk patients for different treatment options aimed at reducing LR, it is essential to identify LR risk factors. Method LR and survival rates of 4157 patients registered 1995-1997 in the Swedish Rectal Cancer Registry were analysed. LR risk factors were analysed by multivariate methods. For LR patients the registry was validated and additional data retrieved. Results The five-year overall and cancer specific survival rates were 45% and 62%. LR was registered in 326 (8%) patients. After R0-resections for tumours in TNM-stages I-III, LR developed in 10% of tumours at 0-5 cm, 8% at 6-10 cm, and 6% at 11-15 cm above the anal verge. Preoperative radiotherapy (RT) reduced the LR rate irrespective of height [0-5 cm: OR 0.50 (0.30-0.83), 6-10 cm: OR 0.42 (0.25-0.71), and 11-15 cm: OR 0.29 (0.13-0.64)]. Patients without preoperative RT had significantly higher LR risk after rectal perforation [OR 2.50 (1.48-4.24)], and almost significantly decreased LR risk when rectal washout was performed [OR 0.65 (0.43-1.00)]. Preoperative RT prolonged time to LR but did not significantly influence survival among LR patients. LR was an isolated tumour manifestation in 103 (39%) patients with validated LR. Conclusions Preoperative RT should be considered for rectal cancer also in the upper third of the rectum. Intraoperative perforation should be avoided, and rectal washout is indicated as valuable. Follow-up for detection of isolated LR is important. Extended follow-up should be considered for patients treated with RT. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1412317
- author
- Jörgren, Fredrik LU ; Johansson, R ; Damber, L and Lindmark, Gudrun LU
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Colorectal Disease
- volume
- 12
- pages
- 977 - 986
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000281953700005
- pmid:19438885
- scopus:79951539497
- ISSN
- 1462-8910
- DOI
- 10.1111/j.1463-1318.2009.01930.x
- language
- English
- LU publication?
- yes
- id
- 03257760-7fb4-4859-b4f4-028392925ddc (old id 1412317)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19438885?dopt=Abstract
- date added to LUP
- 2016-04-04 07:55:42
- date last changed
- 2022-02-05 23:17:02
@article{03257760-7fb4-4859-b4f4-028392925ddc,
abstract = {{Aim Despite advances in rectal cancer treatment local recurrence (LR) remains a significant problem. To select high-risk patients for different treatment options aimed at reducing LR, it is essential to identify LR risk factors. Method LR and survival rates of 4157 patients registered 1995-1997 in the Swedish Rectal Cancer Registry were analysed. LR risk factors were analysed by multivariate methods. For LR patients the registry was validated and additional data retrieved. Results The five-year overall and cancer specific survival rates were 45% and 62%. LR was registered in 326 (8%) patients. After R0-resections for tumours in TNM-stages I-III, LR developed in 10% of tumours at 0-5 cm, 8% at 6-10 cm, and 6% at 11-15 cm above the anal verge. Preoperative radiotherapy (RT) reduced the LR rate irrespective of height [0-5 cm: OR 0.50 (0.30-0.83), 6-10 cm: OR 0.42 (0.25-0.71), and 11-15 cm: OR 0.29 (0.13-0.64)]. Patients without preoperative RT had significantly higher LR risk after rectal perforation [OR 2.50 (1.48-4.24)], and almost significantly decreased LR risk when rectal washout was performed [OR 0.65 (0.43-1.00)]. Preoperative RT prolonged time to LR but did not significantly influence survival among LR patients. LR was an isolated tumour manifestation in 103 (39%) patients with validated LR. Conclusions Preoperative RT should be considered for rectal cancer also in the upper third of the rectum. Intraoperative perforation should be avoided, and rectal washout is indicated as valuable. Follow-up for detection of isolated LR is important. Extended follow-up should be considered for patients treated with RT.}},
author = {{Jörgren, Fredrik and Johansson, R and Damber, L and Lindmark, Gudrun}},
issn = {{1462-8910}},
language = {{eng}},
pages = {{977--986}},
publisher = {{Wiley-Blackwell}},
series = {{Colorectal Disease}},
title = {{Risk Factors of Rectal Cancer Local Recurrence: Population-based Survey and Validation of the Swedish Rectal Cancer Registry.}},
url = {{http://dx.doi.org/10.1111/j.1463-1318.2009.01930.x}},
doi = {{10.1111/j.1463-1318.2009.01930.x}},
volume = {{12}},
year = {{2010}},
}