Pattern of rectal cancer recurrence following potentially curative surgical treatment

Survival in rectal cancer has been related mainly to clinical and pathological staging. Recurrence is the most challenging issue when surgical treatment of rectal cancer is concerned. This study aims to establish a recurrence pattern for rectal adenocarcinoma submitted to surgical treatment between June 2003 and July 2021. After applying the exclusion criteria to 305 patients, 166 patients were analyzed. Global recurrence was found in 18.7% of them, while 7.8% have had local recurrence. Recurrences were diagnosed from 5 to 92 months after the surgical procedure, with a median of 32.5 months. Follow-up varied from 6 to 115 months. Recurrence, in literature, is usually between 3 and 35% in 5 years and shows a 5-year survival rate of only 5%. In around 50% of cases, recurrence is local, confined to the pelvis. This study was consonant with the literature in most aspects evaluated, although a high rate of local recurrence remains a challenge in seeking better surgical outcomes. (AU)

Recurrence pattern of rectal cancer after surgical treatment. Analysis of 122 patients in a tertiary care center / Padrão de recorrência de câncer retal em seguida ao tratamento cirúrgico. Análise de 122 pacientes em um centro terciário

ABSTRACT Survival in rectal cancer has been related mainly to clinical and pathological staging. Recurrence is by far the most challenging issue when surgical treatment of rectal cancer is concerned. This study aims to establish a recurrence pattern for rectal adenocarcinoma submitted to surgical treatment between March 2003 and July 2016. After exclusion criteria were applied, one hundred twenty two patients were analyzed. Global recurrence was found in 22% of them, while 13.1% have had local recurrence. Disease-free survival was 23.9 months, in average, and medium follow-up was 34.13 months, varying from 6 to 115 months. Recurrence, in literature, is usually between 3 and 35% in 5 years, and shows a 5-years survival rate of only 5%. Around 50% of cases, recurrence is local, confined to pelvis. This data followed literature in most aspects evaluated, although finding a high rate of local recurrence remains a challenge in the seek for better surgical outcomes.

RESUMO A sobrevida de pacientes com câncer retal tem sido relacionada, sobretudo, aos estadiamentos clínico e patológico. De longe a recorrência é o problema mais desafiador, no que concerne ao tratamento cirúrgico do câncer retal. Esse estudo pretende estabelecer um padrão de recorrência para pacientes com adenocarcinoma retal submetidos a tratamento cirúrgico entre março de 2003 e julho de 2016. Após a aplicação dos critérios de exclusão, foram analisados 122 pacientes. Recorrência global foi constatada em 22% dos pacientes, enquanto que 13,1% tiveram recorrência localizada. A média para sobrevida livre de doença foi de 23,9 meses, e o acompanhamento médio foi de 34,13 meses, com variação entre 6-115 meses. Na literatura, em geral a recorrência se situa entre 3-35% após 5 anos, com um percentual de sobrevida após 5 anos de apenas 5%. Em cerca de 50% dos casos a recorrência é localizada, ficando confinada à pelve. Os presentes dados acompanharam os achados da literatura na maioria dos aspectos avaliados, embora o achado de elevado percentual de recorrência localizada permaneça ainda um aspecto desafiador na busca de desfechos cirúrgicos mais satisfatórios.