Japan Digestive Disease Week 2022
International Poster Session5 (JDDW)
October 28, 10:42–11:22, Room 15 (Marine Messe Fukuoka Arena Digital Poster Session)
IP-26_S
Disease Recurrence of Locally Advanced Rectal Cancer in Early Postoperative Phase
- 1
- Department of Surgery, Kyoto University Hospital
BACKGROUND: The NCCN Guidelines for Rectal Cancer recommend more intensive postoperative surveillance during the first 2 years after surgery, while the JSCCR Guidelines (Japan) recommend it during the first 3 years.
METHODS: A total of 332 locally advanced rectal cancer patients who underwent curative total mesorectal excision (TME) surgery between Jul-2005 and Feb-2021 were included. First recurrence pattern after TME surgery was assessed. Median follow-up duration was 4.6 years.
RESULTS: Recurrence rate was 24% (N=78). Approximately 80% of the recurrences developed within the first 2 years after surgery, regardless of the presence of preoperative chemotherapy/chemoradiotherapy. Of the 78 disease recurrences, 24% had local recurrence only, 62% distant metastases only, and 14% simultaneous recurrences. Overall, 46% of the recurrences were surgically resectable (8 patients underwent chemotherapy or chemoradiotherapy prior to resection of recurrence), and 75% of the surgically resectable recurrences developed within the first 2 years. Surgical resectability of the “local only” recurrences was high in the early postoperative phase (≤2y vs. >2y after TME surgery, 73% (N=8/11) versus 38% (N=3/8), p=0.18). Also, all of the simultaneous recurrences developed within the first 2 years.
CONCLUSIONS: Our findings indicate that the first 2 years of high-intensity surveillance are reasonable.
METHODS: A total of 332 locally advanced rectal cancer patients who underwent curative total mesorectal excision (TME) surgery between Jul-2005 and Feb-2021 were included. First recurrence pattern after TME surgery was assessed. Median follow-up duration was 4.6 years.
RESULTS: Recurrence rate was 24% (N=78). Approximately 80% of the recurrences developed within the first 2 years after surgery, regardless of the presence of preoperative chemotherapy/chemoradiotherapy. Of the 78 disease recurrences, 24% had local recurrence only, 62% distant metastases only, and 14% simultaneous recurrences. Overall, 46% of the recurrences were surgically resectable (8 patients underwent chemotherapy or chemoradiotherapy prior to resection of recurrence), and 75% of the surgically resectable recurrences developed within the first 2 years. Surgical resectability of the “local only” recurrences was high in the early postoperative phase (≤2y vs. >2y after TME surgery, 73% (N=8/11) versus 38% (N=3/8), p=0.18). Also, all of the simultaneous recurrences developed within the first 2 years.
CONCLUSIONS: Our findings indicate that the first 2 years of high-intensity surveillance are reasonable.
- Index Term 1: rectal cancer
- Index Term 2: surveillance