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KMID : 1141920200360060382
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Annals of Coloproctology
2020 Volume.36 No. 6 p.382 ~ p.389
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Beware of Early Relapse in Rectal Cancer Patients Treated With Preoperative Chemoradiotherapy
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Oh Seul-Gi
Park In-Ja
Seo Ji-Hyun
Kim Young-Il
Lim Seok-Byung
Kim Chan-Wook
Yoon Yong-Sik
Lee Jong-Lyul
Yu Chang-Sik
Kim Jin-Cheon
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Abstract
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Purpose: Recurrence patterns in rectal cancer patients treated with preoperative chemoradiotherapy (PCRT) are needed to evaluate for establishing tailored surveillance protocol.
Methods: This study included 2,215 patients with locally-advanced mid and low rectal cancer treated with radical resection between January 2005 and December 2012. Recurrence was evaluated according to receipt of PCRT; PCRT group (n = 1,258) and no-PCRT group (n = 957). Early recurrence occurred within 1 year of surgery and late recurrence after 3 years. The median follow-up duration was 65.7 ± 29 months.
Results: The overall recurrence rate was similar between the PCRT and no-PCRT group (25.8% vs. 24.9%, P = 0.622). The most common initial recurrence site was the lungs in both groups (50.6% vs. 49.6%, P = 0.864), followed by the liver, which was more common in the no-PCRT group (22.5% vs. 33.6%, P = 0.004). Most of the recurrence occurred within 3 years after surgery in both groups (85.3% vs. 85.8%, P = 0.862). Early recurrence was more common in the PCRT group than in the no-PCRT group (43.1% vs. 32.4%, P = 0.020). Recurrence within the first 6 months after surgery was significantly higher in the PCRT group than in the no-PCRT group (18.8% vs. 7.6%, P = 0.003). Lung (n = 27, 44.3%) and liver (n = 22, 36.1%) were the frequent the first relapsed site within 6 months after surgery in PCRT group.
Conclusion: Early recurrence within the first 1 year after surgery was more common in patients treated with PCRT. This difference would be considered for surveillance protocols and need to be evaluated in further studies.
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KEYWORD
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Rectal neoplasms, Early recurrence, Preoperative chemoradiotherapy, Surveillance, Recurrence pattern
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