Long-term oncological outcomes after local excision of T1 rectal cancer
Background A growing proportion of patients with early rectal cancer is treated by local excision only. The aim of this study was to evaluate long-term oncological outcomes and the impact of local recurrence on overall survival for surgical local excision in pT1 rectal cancer. Methods Patients who o...
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| Veröffentlicht in: | Techniques in coloproctology 2023-01, Vol.27 (1), p.23-33 |
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| creator | Leijtens, J. W. A. Smits, L. J. H. Koedam, T. W. A. Orsini, R. G. van Aalten, S. M. Verseveld, M. Doornebosch, P. G. de Graaf, E. J. R. Tuynman, J. B. |
| description | Background
A growing proportion of patients with early rectal cancer is treated by local excision only. The aim of this study was to evaluate long-term oncological outcomes and the impact of local recurrence on overall survival for surgical local excision in pT1 rectal cancer.
Methods
Patients who only underwent local excision for pT1 rectal cancer between 1997 and 2014 in two Dutch tertiary referral hospitals were included in this retrospective cohort study. The primary outcome was the local recurrence rate. Secondary outcomes were distant recurrence, overall survival and the impact of local recurrence on overall survival.
Results
A total of 150 patients (mean age 68.5 ± 10.7 years, 57.3% males) were included in the study. Median length of follow-up was 58.9 months (range 6–176 months). Local recurrence occurred in 22.7% (
n
= 34) of the patients, with a median time to local recurrence of 11.1 months (range 2.3–82.6 months). The vast majority of local recurrences were located in the lumen. Five-year overall survival was 82.0%, and landmark analyses showed that local recurrence significantly impacted overall survival at 6 and 36 months of follow-up (6 months,
p
= 0.034, 36 months,
p
= 0.036).
Conclusions
Local recurrence rates after local excision of early rectal cancer can be substantial and may impact overall survival. Therefore, clinical decision-making should be based on patient- and tumour characteristics and should incorporate patient preferences. |
| doi_str_mv | 10.1007/s10151-022-02661-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9807482</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2707599309</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-e0459a44b131bafe89da24d5e4436af1c75f2b310574809be8f9ba1c7dc8c0dd3</originalsourceid><addsrcrecordid>eNp9kUtv1TAQhS0Eog_4AyyqSGy6CczYTmxvKqGKPqQrsSkSO8txJpdUid3aCYJ_X7e3lMKChWXrzDfHMzqMvUP4gADqY0bABmvgvJy2xbp9wfYRua5BNt9ePrxF3Qqh9thBztcAqFSDr9meaIFrpfk-O9_EsK0XSnMVg49T3I7eTVVcFx9nypUbSq2a4r1IP_2YxxiqOFRXWCXyS1G9C57SG_ZqcFOmt4_3Ift69vnq9KLefDm_PP20qb1UcqmpTGaclB0K7NxA2vSOy74hKUXrBvSqGXgnEBolNZiO9GA6V-Teaw99Lw7Zyc73Zu1m6j2FJbnJ3qRxdumXjW60f1fC-N1u4w9rNBRLXgyOHw1SvF0pL3Yes6dpcoHimi1XoBpjBJiCvv8HvY5rCmW9QrWARqtGForvKJ9izomGp2EQ7H1OdpeTLTnZh5xsW5qOnq_x1PI7mAKIHZBLKWwp_fn7P7Z38wCeXw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2760198754</pqid></control><display><type>article</type><title>Long-term oncological outcomes after local excision of T1 rectal cancer</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Leijtens, J. W. A. ; Smits, L. J. H. ; Koedam, T. W. A. ; Orsini, R. G. ; van Aalten, S. M. ; Verseveld, M. ; Doornebosch, P. G. ; de Graaf, E. J. R. ; Tuynman, J. B.</creator><creatorcontrib>Leijtens, J. W. A. ; Smits, L. J. H. ; Koedam, T. W. A. ; Orsini, R. G. ; van Aalten, S. M. ; Verseveld, M. ; Doornebosch, P. G. ; de Graaf, E. J. R. ; Tuynman, J. B.</creatorcontrib><description>Background
A growing proportion of patients with early rectal cancer is treated by local excision only. The aim of this study was to evaluate long-term oncological outcomes and the impact of local recurrence on overall survival for surgical local excision in pT1 rectal cancer.
Methods
Patients who only underwent local excision for pT1 rectal cancer between 1997 and 2014 in two Dutch tertiary referral hospitals were included in this retrospective cohort study. The primary outcome was the local recurrence rate. Secondary outcomes were distant recurrence, overall survival and the impact of local recurrence on overall survival.
Results
A total of 150 patients (mean age 68.5 ± 10.7 years, 57.3% males) were included in the study. Median length of follow-up was 58.9 months (range 6–176 months). Local recurrence occurred in 22.7% (
n
= 34) of the patients, with a median time to local recurrence of 11.1 months (range 2.3–82.6 months). The vast majority of local recurrences were located in the lumen. Five-year overall survival was 82.0%, and landmark analyses showed that local recurrence significantly impacted overall survival at 6 and 36 months of follow-up (6 months,
p
= 0.034, 36 months,
p
= 0.036).
Conclusions
Local recurrence rates after local excision of early rectal cancer can be substantial and may impact overall survival. Therefore, clinical decision-making should be based on patient- and tumour characteristics and should incorporate patient preferences.</description><identifier>ISSN: 1123-6337</identifier><identifier>EISSN: 1128-045X</identifier><identifier>DOI: 10.1007/s10151-022-02661-6</identifier><identifier>PMID: 36028782</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adenocarcinoma - surgery ; Aged ; Colorectal cancer ; Colorectal Surgery ; Digestive System Surgical Procedures ; Female ; Gastroenterology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Original ; Original Article ; Patients ; Proctology ; Rectal Neoplasms - pathology ; Retrospective Studies ; Surgery ; Tertiary Care Centers ; Treatment Outcome</subject><ispartof>Techniques in coloproctology, 2023-01, Vol.27 (1), p.23-33</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-e0459a44b131bafe89da24d5e4436af1c75f2b310574809be8f9ba1c7dc8c0dd3</citedby><cites>FETCH-LOGICAL-c474t-e0459a44b131bafe89da24d5e4436af1c75f2b310574809be8f9ba1c7dc8c0dd3</cites><orcidid>0000-0001-5889-7939</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10151-022-02661-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10151-022-02661-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36028782$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leijtens, J. W. A.</creatorcontrib><creatorcontrib>Smits, L. J. H.</creatorcontrib><creatorcontrib>Koedam, T. W. A.</creatorcontrib><creatorcontrib>Orsini, R. G.</creatorcontrib><creatorcontrib>van Aalten, S. M.</creatorcontrib><creatorcontrib>Verseveld, M.</creatorcontrib><creatorcontrib>Doornebosch, P. G.</creatorcontrib><creatorcontrib>de Graaf, E. J. R.</creatorcontrib><creatorcontrib>Tuynman, J. B.</creatorcontrib><title>Long-term oncological outcomes after local excision of T1 rectal cancer</title><title>Techniques in coloproctology</title><addtitle>Tech Coloproctol</addtitle><addtitle>Tech Coloproctol</addtitle><description>Background
A growing proportion of patients with early rectal cancer is treated by local excision only. The aim of this study was to evaluate long-term oncological outcomes and the impact of local recurrence on overall survival for surgical local excision in pT1 rectal cancer.
Methods
Patients who only underwent local excision for pT1 rectal cancer between 1997 and 2014 in two Dutch tertiary referral hospitals were included in this retrospective cohort study. The primary outcome was the local recurrence rate. Secondary outcomes were distant recurrence, overall survival and the impact of local recurrence on overall survival.
Results
A total of 150 patients (mean age 68.5 ± 10.7 years, 57.3% males) were included in the study. Median length of follow-up was 58.9 months (range 6–176 months). Local recurrence occurred in 22.7% (
n
= 34) of the patients, with a median time to local recurrence of 11.1 months (range 2.3–82.6 months). The vast majority of local recurrences were located in the lumen. Five-year overall survival was 82.0%, and landmark analyses showed that local recurrence significantly impacted overall survival at 6 and 36 months of follow-up (6 months,
p
= 0.034, 36 months,
p
= 0.036).
Conclusions
Local recurrence rates after local excision of early rectal cancer can be substantial and may impact overall survival. Therefore, clinical decision-making should be based on patient- and tumour characteristics and should incorporate patient preferences.</description><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - surgery</subject><subject>Aged</subject><subject>Colorectal cancer</subject><subject>Colorectal Surgery</subject><subject>Digestive System Surgical Procedures</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Proctology</subject><subject>Rectal Neoplasms - pathology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Tertiary Care Centers</subject><subject>Treatment Outcome</subject><issn>1123-6337</issn><issn>1128-045X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kUtv1TAQhS0Eog_4AyyqSGy6CczYTmxvKqGKPqQrsSkSO8txJpdUid3aCYJ_X7e3lMKChWXrzDfHMzqMvUP4gADqY0bABmvgvJy2xbp9wfYRua5BNt9ePrxF3Qqh9thBztcAqFSDr9meaIFrpfk-O9_EsK0XSnMVg49T3I7eTVVcFx9nypUbSq2a4r1IP_2YxxiqOFRXWCXyS1G9C57SG_ZqcFOmt4_3Ift69vnq9KLefDm_PP20qb1UcqmpTGaclB0K7NxA2vSOy74hKUXrBvSqGXgnEBolNZiO9GA6V-Teaw99Lw7Zyc73Zu1m6j2FJbnJ3qRxdumXjW60f1fC-N1u4w9rNBRLXgyOHw1SvF0pL3Yes6dpcoHimi1XoBpjBJiCvv8HvY5rCmW9QrWARqtGForvKJ9izomGp2EQ7H1OdpeTLTnZh5xsW5qOnq_x1PI7mAKIHZBLKWwp_fn7P7Z38wCeXw</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Leijtens, J. W. A.</creator><creator>Smits, L. J. H.</creator><creator>Koedam, T. W. A.</creator><creator>Orsini, R. G.</creator><creator>van Aalten, S. M.</creator><creator>Verseveld, M.</creator><creator>Doornebosch, P. G.</creator><creator>de Graaf, E. J. R.</creator><creator>Tuynman, J. B.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5889-7939</orcidid></search><sort><creationdate>20230101</creationdate><title>Long-term oncological outcomes after local excision of T1 rectal cancer</title><author>Leijtens, J. W. A. ; Smits, L. J. H. ; Koedam, T. W. A. ; Orsini, R. G. ; van Aalten, S. M. ; Verseveld, M. ; Doornebosch, P. G. ; de Graaf, E. J. R. ; Tuynman, J. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-e0459a44b131bafe89da24d5e4436af1c75f2b310574809be8f9ba1c7dc8c0dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - surgery</topic><topic>Aged</topic><topic>Colorectal cancer</topic><topic>Colorectal Surgery</topic><topic>Digestive System Surgical Procedures</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Proctology</topic><topic>Rectal Neoplasms - pathology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Tertiary Care Centers</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leijtens, J. W. A.</creatorcontrib><creatorcontrib>Smits, L. J. H.</creatorcontrib><creatorcontrib>Koedam, T. W. A.</creatorcontrib><creatorcontrib>Orsini, R. G.</creatorcontrib><creatorcontrib>van Aalten, S. M.</creatorcontrib><creatorcontrib>Verseveld, M.</creatorcontrib><creatorcontrib>Doornebosch, P. G.</creatorcontrib><creatorcontrib>de Graaf, E. J. R.</creatorcontrib><creatorcontrib>Tuynman, J. B.</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Techniques in coloproctology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leijtens, J. W. A.</au><au>Smits, L. J. H.</au><au>Koedam, T. W. A.</au><au>Orsini, R. G.</au><au>van Aalten, S. M.</au><au>Verseveld, M.</au><au>Doornebosch, P. G.</au><au>de Graaf, E. J. R.</au><au>Tuynman, J. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term oncological outcomes after local excision of T1 rectal cancer</atitle><jtitle>Techniques in coloproctology</jtitle><stitle>Tech Coloproctol</stitle><addtitle>Tech Coloproctol</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>27</volume><issue>1</issue><spage>23</spage><epage>33</epage><pages>23-33</pages><issn>1123-6337</issn><eissn>1128-045X</eissn><abstract>Background
A growing proportion of patients with early rectal cancer is treated by local excision only. The aim of this study was to evaluate long-term oncological outcomes and the impact of local recurrence on overall survival for surgical local excision in pT1 rectal cancer.
Methods
Patients who only underwent local excision for pT1 rectal cancer between 1997 and 2014 in two Dutch tertiary referral hospitals were included in this retrospective cohort study. The primary outcome was the local recurrence rate. Secondary outcomes were distant recurrence, overall survival and the impact of local recurrence on overall survival.
Results
A total of 150 patients (mean age 68.5 ± 10.7 years, 57.3% males) were included in the study. Median length of follow-up was 58.9 months (range 6–176 months). Local recurrence occurred in 22.7% (
n
= 34) of the patients, with a median time to local recurrence of 11.1 months (range 2.3–82.6 months). The vast majority of local recurrences were located in the lumen. Five-year overall survival was 82.0%, and landmark analyses showed that local recurrence significantly impacted overall survival at 6 and 36 months of follow-up (6 months,
p
= 0.034, 36 months,
p
= 0.036).
Conclusions
Local recurrence rates after local excision of early rectal cancer can be substantial and may impact overall survival. Therefore, clinical decision-making should be based on patient- and tumour characteristics and should incorporate patient preferences.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>36028782</pmid><doi>10.1007/s10151-022-02661-6</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-5889-7939</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Abdominal Surgery Adenocarcinoma - surgery Aged Colorectal cancer Colorectal Surgery Digestive System Surgical Procedures Female Gastroenterology Humans Male Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local - surgery Neoplasm Staging Original Original Article Patients Proctology Rectal Neoplasms - pathology Retrospective Studies Surgery Tertiary Care Centers Treatment Outcome |
| title | Long-term oncological outcomes after local excision of T1 rectal cancer |
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