Influence of Histomorphological Parameters and Ploidy on Recurrence-Free Survival Time in Early Rectal Cancer after Local Excision

1993 ◽  
Vol 10 (6) ◽  
pp. 300-305
Author(s):  
T. Böttger ◽  
A. Heinz ◽  
D. Potratz ◽  
M. Stöckle ◽  
T. Junginger
Keyword(s):  
Rectal Cancer ◽  
Survival Time ◽  
Local Excision ◽  
Recurrence Free Survival ◽  
Early Rectal Cancer ◽  
Free Survival

scholarly journals Completion surgery vs. primary TME for early rectal cancer: a national study

2021 ◽  
Author(s):  
William J. Lossius ◽  
Tore Stornes ◽  
Tor A. Myklebust ◽  
Birger H. Endreseth ◽  
Arne Wibe
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
Resected Specimen ◽  
Early Rectal Cancer ◽  
Free Survival ◽  
Permanent Stoma ◽  
Completion Surgery ◽  
Disease Free

Abstract Purpose While local excision by transanal endoscopic microsurgery (TEM) or transanal minimally invasive surgery (TAMIS) is an option for low-risk early rectal cancers, inaccuracies in preoperative staging may be revealed only upon histopathological evaluation of the resected specimen, demanding completion surgery (CS) by formal resection. The aim of this study was to evaluate the results of CS in a national cohort. Method This was a retrospective analysis of national registry data, identifying and comparing all Norwegian patients who, without prior radiochemotherapy, underwent local excision by TEM or TAMIS and subsequent CS, or a primary total mesorectal excision (pTME), for early rectal cancer during 2000–2017. Primary endpoints were 5-year overall and disease-free survival, 5-year local and distant recurrence, and the rate of R0 resection at completion surgery. The secondary endpoint was the rate of permanent stoma. Results Forty-nine patients received CS, and 1098 underwent pTME. There was no difference in overall survival (OR 0.73, 95% CI 0.27–2.01), disease-free survival (OR 0.72, 95% CI 0.32–1.63), local recurrence (OR 1.08, 95% CI 0.14–8.27) or distant recurrence (OR 0.67, 95% CI 0.21–2.18). In the CS group, 53% had a permanent stoma vs. 32% in the pTME group (P = 0.002); however, the difference was not significant when adjusted for age, sex, and tumor level (OR 2.17, 0.95–5.02). Conclusions Oncological results were similar in the two groups. However, there may be an increased risk for a permanent stoma in the CS group.

scholarly journals Postoperative non-steroidal anti-inflammatory drug use and oncological outcomes of rectal cancer

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
O Grahn ◽  
M Lundin ◽  
M-L Lydrup ◽  
E Angenete ◽  
M Rutegård
Keyword(s):  
Rectal Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Instrumental Variables ◽  
Cox Regression ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Anti Inflammatory ◽  
Instrumental Variables Approach

Abstract Background Non-steroidal anti-inflammatory drugs (NSAIDs) are known to suppress the inflammatory response after surgery and are often used for pain control. This study aimed to investigate NSAID use after radical surgical resection for rectal cancer and long-term oncological outcomes. Methods A cohort of patients who underwent anterior resection for rectal cancer between 2007 and 2013 in 15 hospitals in Sweden was investigated retrospectively. Data were obtained from the Swedish Colorectal Cancer Registry and medical records; follow-up was undertaken until July 2019. Patients who received NSAID treatment for at least 2 days after surgery were compared with controls who did not, and the primary outcome was recurrence-free survival. Cox regression modelling with confounder adjustment, propensity score matching, and an instrumental variables approach were used; missing data were handled by multiple imputation. Results The cohort included 1341 patients, 362 (27.0 per cent) of whom received NSAIDs after operation. In analyses using conventional regression and propensity score matching, there was no significant association between postoperative NSAID use and recurrence-free survival (adjusted hazard ratio (HR) 1.02, 0.79 to 1.33). The instrumental variables approach, including individual hospital as the instrumental variable and clinicopathological variables as co-variables, suggested a potential improvement in the NSAID group (HR 0.61, 0.38 to 0.99). Conclusion Conventional modelling did not demonstrate an association between postoperative NSAID use and recurrence-free survival in patients with rectal cancer, although an instrumental variables approach suggested a potential benefit.

scholarly journals Wide Local Excision for Dermatofibrosarcoma Protuberans: A Single-Center Series of 90 Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Byung Jun Kim ◽  
Hyeonwoo Kim ◽  
Ung Sik Jin ◽  
Kyung Won Minn ◽  
Hak Chang
Keyword(s):  
Local Recurrence ◽  
Local Excision ◽  
Wide Local Excision ◽  
Safety Margin ◽  
Dermatofibrosarcoma Protuberans ◽  
Low Grade ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Incomplete Removal ◽  
Surgical Methods

Background. Dermatofibrosarcoma protuberans (DFSP), a rare low-grade sarcoma of fibroblast origin, tends to extend in a finger-like fashion beyond macroscopic tumor margins. Therefore, incomplete removal and subsequent recurrence are common. This study aimed to determine the efficacy of wide local excision (WLE) for controlling local recurrence of DFSP.Methods. The medical records of 90 DFSP patients who received WLE at our hospital between June 1992 and January 2015 were retrospectively reviewed. WLE was conducted including a 3 cm (range, 1 to 5 cm) safety margin according to tumor size, location, and recurrence status. Clinical and tumor characteristics and surgical methods were evaluated for risk factor analysis and local recurrence-free survival.Results. DFSP occurred most often in patients in their 30s (30%) and on the trunk (51.1%). Five patients (5.5%) experienced local recurrence during the 43.4-month follow-up period. Recurrence was found at a mean of 10.8 months after WLE. Although no factors were significantly associated with recurrence, recurrences were more frequent in head and neck. Recurrence-free survival was 87% in 6 years and 77% in 7 years.Conclusions. WLE with adequate lateral and deep margins can effectively control local recurrence rate and is a simple and effective method to treat DFSP.

Are we doing too much?: local excision before radical surgery in early rectal cancer

2018 ◽  
Vol 33 (4) ◽  
pp. 383-391
Author(s):  
Sun Min Park ◽  
Bong-Hyeon Kye ◽  
Min Ki Kim ◽  
Heba E. Jalloun ◽  
Hyeon-Min Cho ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Radical Surgery ◽  
Early Rectal Cancer

scholarly journals Long-Term Outcomes of Local Excision Following Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

2020 ◽  
Author(s):  
Lucrezia D’Alimonte ◽  
Quoc Riccardo Bao ◽  
Gaya Spolverato ◽  
Giulia Capelli ◽  
Paola Del Bianco ◽  
...  
Keyword(s):  
Local Excision ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Recurrence Free Survival ◽  
Long Term Outcomes ◽  
Relapse Free Survival ◽  
Free Survival

Abstract Background Local excision might represent an alternative to total mesorectal excision for patients with locally advanced rectal cancer who achieve a major or complete clinical response after neoadjuvant chemoradiotherapy. Methods Between August 2005 and July 2011, 63 patients with mid-low rectal adenocarcinoma who had a major/complete clinical response after neoadjuvant chemoradiotherapy were enrolled in a multicenter prospective phase 2 trial and underwent transanal full thickness local excision. The main endpoint of this study was to evaluate the 5- and 10-year overall, relapse-free, local, and distant relapse-free survival, which were calculated by applying the Kaplan–Meier method. The rate of patients with rectum preserved and without stoma were also calculated. Results Of 63 patients, 38 (60%) were male and 25 (40%) were female, with a median (range) age of 64 (25–82) years. At baseline, the following clinical stages were found: cT2, n = 21 (33.3%); cT3, n = 42 (66.6%), 39 (61.9%) patients were cN+. At a median (range) follow-up of 108 (32–166) months, the estimated cumulative 5- and 10-year overall survival, relapse-free survival, local recurrence-free survival, and distant recurrence-free survival were 87% (95% CI 76–93) and 79% (95% CI 66–87), 89% (95% CI 78–94) and 82% (95% CI 66–91), both 91% (95% CI 81–96), and 90% (95% CI 80–95) and 86% (95% CI 73–93), respectively. Overall, 49 (77.8%) patients had their rectum preserved, and 54 (84.1%) were stoma-free. Conclusion In highly selected patients, the local excision approach after neoadjuvant chemoradiotherapy is associated with excellent long-term outcomes, high rates of rectum preservation and absence of permanent stoma.

Effect of adjuvant chemotherapy on recurrence-free survival varies by neo-adjuvant treatment in patients with stage III rectal cancer

2015 ◽  
Vol 41 (12) ◽  
pp. 1630-1635 ◽  
Author(s):  
F.N. van Erning ◽  
H.J.T. Rutten ◽  
H.A. van den Berg ◽  
V.E.P.P. Lemmens ◽  
H.K. van Halteren
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Treatment ◽  
Stage Iii ◽  
Recurrence Free Survival ◽  
Free Survival
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