Redo Pelvic Surgery and Combined Metastectomy for Locally Recurrent Rectal Cancer with Known Oligometastatic Disease: A Multicentre Review

Keogh, C; O&#39;Sullivan, NJ; Temperley, HC; Flood, MP; Ting, P; Walsh, C; Waters, P; Ryan, EJ; Conneely, JB; Edmundson, A; Larkin, JO; McCormick, JJ; Mehigan, BJ; Taylor, D; Warrier, S; McCormick, PH; Soucisse, ML; Harris, CA; Heriot, AG; Kelly, ME

Author(s): Keogh, C; O'Sullivan, NJ; Temperley, HC; Flood, MP; Ting, P; Walsh, C; Waters, P; Ryan, EJ; Conneely, JB; Edmundson, A; Larkin, JO; McCormick, JJ; Mehigan, BJ; Taylor, D; Warrier, S; McCormick, PH; Soucisse, ML; Harris, CA; Heriot, AG; Kelly, ME;
Details: Publication Year 2023-09-08,Volume 15,Issue #18,Page 4469
Journal Title: Cancers
Publication Type: Research article
Abstract: INTRODUCTION: Historically, surgical resection for patients with locally recurrent rectal cancer (LRRC) had been reserved for those without metastatic disease. 'Selective' patients with limited oligometastatic disease (OMD) (involving the liver and/or lung) are now increasingly being considered for resection, with favourable five-year survival rates. METHODS: A retrospective analysis of consecutive patients undergoing multi-visceral pelvic resection of LRRC with their oligometastatic disease between 1 January 2015 and 31 August 2021 across four centres worldwide was performed. The data collected included disease characteristics, neoadjuvant therapy details, perioperative and oncological outcomes. RESULTS: Fourteen participants with a mean age of 59 years were included. There was a female preponderance (n = 9). Nine patients had liver metastases, four had lung metastases and one had both lung and liver disease. The mean number of metastatic tumours was 1.5 +/- 0.85. R0 margins were obtained in 71.4% (n = 10) and 100% (n = 14) of pelvic exenteration and oligometastatic disease surgeries, respectively. Mean lymph node yield was 11.6 +/- 6.9 nodes, with positive nodes being found in 28.6% (n = 4) of cases. A single major morbidity was reported, with no perioperative deaths. At follow-up, the median disease-free survival and overall survival were 12.3 months (IQR 4.5-17.5 months) and 25.9 months (IQR 6.2-39.7 months), respectively. CONCLUSIONS: Performing radical multi-visceral surgery for LRRC and distant oligometastatic disease appears to be feasible in appropriately selected patients that underwent good perioperative counselling.
Publisher: MDPI
Keywords: combined metastasectomy; locally recurrent rectal cancer; recurrence
Department(s): Surgical Oncology
PubMed ID: 37760439
Publisher's Version: https://doi.org/10.3390/cancers15184469
Open Access at Publisher's Site: https://doi.org/10.3390/cancers15184469
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-11-21 05:54:18

Last Modified: 2023-11-21 05:55:40