Details

Autor(en) / Beteiligte

• Zitt, Matthias
• DeVries, Alexander
• Thaler, Josef
• Kafka-Ritsch, Reinhold
• Eisterer, Wolfgang
• Lukas, Peter
• Öfner, Dietmar

Titel

Long-term surveillance of locally advanced rectal cancer patients with neoadjuvant chemoradiation and aggressive surgical treatment of recurrent disease: a consecutive single-centre experience

Ist Teil von

• International journal of colorectal disease, 2015-12, Vol.30 (12), p.1705-1714

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2015

Quelle

SpringerLink

Beschreibungen/Notizen

• Purpose The aim of this study was to analyse the long-term outcome of rectal cancer patients who submitted to preoperative chemoradiation with consecutive intensive follow-up and aggressive surgical treatment of recurrent disease. Methods Patients with locally advanced (cT3-4 Nx M0-1) mid/low rectal cancer were treated at a tertiary university hospital with preoperative long-course chemoradiation followed by resection (according to a prospective study protocol). After resection, all patients were urged to participate in a standardised, risk-independent intensive follow-up program. All curatively treated patients ( n  = 153, 96 %) were included in our long-term analysis with respect to curative re-resection of recurrent disease. Results Of 153 patients, 143 (93 %) participated in our follow-up program: 63 % were surveyed longer than 5 years after primary therapy (mean follow-up 75 months, 95 % CI 67.8–82.2). Fifty-five (36 %) patients developed cancer recurrence (mean 27.8 months, 95 % CI 20.6–34.9, range 3–108), giving a disease-free survival rate of 68.5 and 60.7 % at 5 and 10 years; 21 (38 %) patients were re-resected curatively and 58 (38 %) patients died during the observation period, giving an overall survival rate of 70.8 and 57.5 % at 5 and 10 years. Multivariate analysis found tumour differentiation ( P  < 0.01), operative procedure ( P  < 0.05) and downstaging ( P  < 0.01) to be independent variables influencing overall survival. Conclusions The combination of multimodal therapy and aggressive surgical treatment of metastases including repeated re-resections in curative intention is relevant in order to chronify the disease. Thus, both intensive and extended follow-up beyond 5 years appear to be mandatory.