Late Local Recurrence after Neoadjuvant Therapy and Radical Resection for Locally Advanced Rectal Cancer

Author:

Salega Adrian1,Münch Marina1,Renner Philipp1,Thon Klaus-Peter1,Steurer Wolfgang2,Mönch Dina34ORCID,Koch Jana34ORCID,Maaß Annika34,Schlitt Hans Jürgen5ORCID,Dahlke Marc-Hendrik1,Leibold Tobias1

Affiliation:

1. Robert Bosch Centre for Tumour Diseases (RBCT), Department of General and Visceral Surgery, Robert-Bosch-Hospital, 70376 Stuttgart, Germany

2. Department of Surgery, Klinikverbund Südwest, Krankenhaus Leonberg, 71229 Leonberg, Germany

3. Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany

4. University of Tübingen, 72074 Tübingen, Germany

5. Department of Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany

Abstract

Neoadjuvant radiochemotherapy (RCT) and lately total neoadjuvant therapy (TNT) improved local recurrence rates of rectal cancer significantly compared to total mesorectal excision (TME) alone. Yet the occurrence and impact of late local recurrences after many years appears to be a distinct biological problem. We included n = 188 patients with rectal cancer after RCT and radical resection in this study; n = 38 of which had recurrent disease (sites: local (8.0%), liver (6.4%), lung (3.7%)). We found that 68% of all recurrences developed within the first two years. Four patients, however, experience recurrence >8 years after surgery. Here, we report and characterize four cases of late local recurrence (10% of patients with recurrent disease), suggesting that neoadjuvant therapy in principle delays local recurrence.

Publisher

MDPI AG

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