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Journals / Batı Karadeniz Tıp Dergisi / 2024 / Cilt: 8 Sayı: 3

Five Year Follow Up Results of Surgically Treated Rectal Cancer Case, Who Had Neoadjuvan Chemotheraph

Neoadjuvan Kemoterapi Uygulanan Cerrahi Tedavi Görmüş Rektal Kanser Olgularında Beş Yıllık Takip Sonuçları

Kazim Şahin(KANDIRA DEVLET HASTANESİ)0000-0002-5485-2351
Enes Şahin(KOCAELİ ÜNİVERSİTESİ)0000-0003-3777-8468
Ecenur Varol(KOCAELİ ÜNİVERSİTESİ)0000-0003-1276-7279
Fatih Koç(KOCAELİ ÜNİVERSİTESİ)0000-0002-6445-3207
Haşim Köken(KOCAELİ ÜNİVERSİTESİ)0000-0002-1185-2677
Sertaç Ata Güler(KOCAELİ ÜNİVERSİTESİ)0000-0003-1616-9436
Zafer Utkan(KOCAELİ ÜNİVERSİTESİ)0000-0002-2133-3336
Pages
283–290
Publication Date
2024-12-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Early surgery is recommended as the first-line treatment for early-stage rectal cancer due to its favorable outcomes.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aim: We wanted to investigate whether the watch and wait method without surgery or surgery is superior in patients with rectal cancer receiving neoadjuvant treatment.
📊
Key Findings & Data:Material and Methods: The clinical data of case above the age of 18 who were diagnosed with rectal tumors between 2018 and 2023 were retrospectively analyzed.
💡
Conclusion & Impact:Early surgery is recommended as the first-line treatment for early-stage rectal cancer due to its favorable outcomes.
🔬Design:Survey & Empirical Study
📍Scope:2018 Verileri
⚙️Variables:Rektal kanser · neoadjuvan tedavi · izle ve bekle

Abstract

Aim: We wanted to investigate whether the watch and wait method without surgery or surgery is superior in patients with rectal cancer receiving neoadjuvant treatment. Material and Methods: The clinical data of case above the age of 18 who were diagnosed with rectal tumors between 2018 and 2023 were retrospectively analyzed. Results: After neoadjuvant treatment, the mass disappeared completely in some case. All case were operated after neoadjuvant treatment. Adenocarcinoma was seen in 140 (80%) case operated after neoadjuvant treatment, normal colon wall was seen in 10 (5.5%) case and chronic inflammation was seen in 20 (11%) case. Conclusion: The importance of neoadjuvant treatment according to the stage of the disease in case with rectal cancer is being better understood day by day. Early surgery is recommended as the first-line treatment for early-stage rectal cancer due to its favorable outcomes. However, it has been widely accepted that in locally advanced or advanced rectal cancers with lymph node metastasis, neoadjuvant treatment before surgery is much more beneficial in terms of disease-free survival and survey after surgery

Özet

Amaç: Neoadjuvan tedavi alan rektum kanserli olgularda cerrahi yapılmadan izle ve bekle yönteminin mi yoksa operasyon yapılmasının mı daha üstün olduğunu araştırmak istedik. Gereç ve Yöntemler: 2018-2023 yılları arasında rektum tümörü tanısı alan 18 yaş üstü olguların klinik verileri retrospektif olarak analiz edildi. Bulgular: Neoadjuvan tedavi sonrasında bazı olgularda kitle tamamen kayboldu. Tüm olgular neoadjuvan tedavi sonrası opere edildi. Neoadjuvan tedavi sonrası opere edilen 140 (80%) olguda adenokarsinom, 10 (5.5%) olguda normal kolon duvarı ve 20 (11%) olguda kronik inflamasyon görüldü. Sonuç: Rektum kanserli olgularda hastalığın evresine göre neoadjuvan tedavinin önemi gün geçtikçe daha iyi anlaşılmaktadır. Erken evre rektum kanserinde erken cerrahi, olumlu sonuçları nedeniyle ilk basamak tedavi olarak önerilmektedir. Ancak lenf nodu metastazı olan lokal ileri veya ileri evre rektum kanserlerinde cerrahi öncesi neoadjuvan tedavinin olgularda sağkalım ve cerrahi sonrası sağkalım açısından çok daha faydalı olduğu yaygın olarak kabul görmektedir

🔖

Cite This Article

Şahin, K., Şahin, E., Varol, E., Koç, F., Köken, H., Güler, S. A., Utkan, Z. (2024). Five Year Follow Up Results of Surgically Treated Rectal Cancer Case, Who Had Neoadjuvan Chemotheraph. Batı Karadeniz Tıp Dergisi, Cilt: 8 Sayı: 3, 283–290. https://doi.org/10.29058/mjwbs.1441047

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References (36)

  1. Siegel, R. L., Miller, K. D. Jemal, A. Cancer statistics, 2018. CA Cancer J. Clin. 68, 7–30 (2018).
  2. Kanser İstatistikleri. Accessed April 23, 2024. https://hsgm.saglik. gov.tr/tr/kanser-istatistikleri.html
  3. Mary R. Kwaan, David B. Stewart Sr, and Kelli Bullard Dunn, Schwartz’s Principles of Surgery Eleventh Edition, chapter 29; Colon, Rectum, and Anus, pp 1259-1329.
  4. Day DW. The adenoma-carcinoma sequence. Scand J Gastroenterol Suppl. 1984;104:99-107.
  5. Benjamin Yongcheng Tan MBBS, FRCPath, Puay Hoon Tan MBBS, FRCPA, FRCPath, in Surgical Pathology Clinics, 2018 Tubular Adenoma - an overview | ScienceDirect Topics. Accessed April 23, 2024. https://www.sciencedirect.com/topics/ medicine-and-dentistry/tubular-adenoma
  6. David J. Myers; Komal Arora. Villous Adenoma - StatPearls - NCBI Bookshelf. Accessed April 23, 2024. https://www.ncbi. nlm.nih.gov/books/NBK470272/
  7. Colorectal Cancer Collaborative Group. Surgery for colorectal cancer in elderly case: a systematic review. Lancet. 2000;356:968–974.
  8. Al-Abed Y, Parker M, Arulampalam T, Tutton M. Survival following rectal cancer surgery: does the age matter? Acta Chir Belg. 2019 Oct;119(5):282–8.
  9. Bates DDB, Homsi ME, Chang KJ, Lalwani N, Horvat N, Sheedy SP. MRI for Rectal Cancer: Staging, mrCRM, EMVI, Lymph Node Staging and Post-Treatment Response. Clin Colorectal Cancer. 2022 Mar;21(1):10–8.
  10. Julio Garcia-Aguilar, Qian Shi, Charles R Thomas Jr, Emily Chan, Peter Cataldo, Jorge Marcet, David Medich, Alessio Pigazzi, Samuel Oommen, Mitchell C Posner. A phase II trial of neoadjuvant chemoradiation and local excision for T2N0 rectal cancer: preliminary results of the ACOSOG Z6041 trial. Ann Surg Oncol. 2012;19:384-391.
  11. Garcia-Aguilar J, Shi Q, Thomas CR, Chan E, Cataldo P, Marcet J, Medich D, Pigazzi A, Oommen S, Posner MC. A phase II trial of neoadjuvant chemoradiation and local excision for T2N0 rectal cancer: preliminary results of the ACOSOG Z6041 trial. Ann Surg Oncol. 2012 Feb;19(2):384–91.
  12. You YN, Baxter NN, Stewart A, Nelson H. Is the Increasing Rate of Local Excision for Stage I Rectal Cancer in the United States Justified?: A Nationwide Cohort Study From the National Cancer Database. Ann Surg. 2007 May;245(5):726.
  13. van Oostendorp SE, Smits LJH, Vroom Y, Detering R, Heymans MW, Moons LMG, Tanis PJ, de Graaf EJR, Cunningham C, Denost Q, Kusters M, Tuynman JB. Local recurrence after local excision of early rectal cancer: a meta-analysis of completion TME, adjuvant (chemo)radiation, or no additional treatment. Br J Surg. 2020 Dec 1;107(13):1719–30.
  14. Garcia-Aguilar J, Renfro LA, Chow OS, Shi Q, Carrero XW, Lynn PB, Thomas CR, Chan E, Cataldo PA, Marcet JE, Medich DS, Johnson CS, Oommen SC, Wolff BG, Pigazzi A, McNevin SM, Pons RK, Bleday R. Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single- arm, multi-institutional, phase 2 trial. Lancet Oncol. 2015 Nov 1;16(15):1537–46.
  15. Shaikh I, Askari A, Ourû S, Warusavitarne J, Athanasiou T, Faiz O. Oncological outcomes of local excision compared with radical surgery after neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis. 2015 Jan 1;30(1):19–29.
  16. Long-Term Survival After Transanal Excision of T1 Rectal Can.: Diseases of the Colon & Rectum [Internet]. [cited 2024 Jan 7]. Available from: https://journals.lww.com/dcrjournal/abstract/ 2009/04000/long_term_survival_after_transanal_excision_ of_t1.4.aspx
  17. Zhifei Sun, Mohamed A Adam, Jina Kim, Daniel P Nussbaum, Ehsan Benrashid, Christopher R Mantyh, John Migaly Determining the optimal timing for initiation of adjuvant chemotherapy after resection for Stage II and III colon cancer. Dis Colon Rectum. 2016;59(2):87-93.
  18. Cercek A, Garcia-Aguilar J. Rectal cancer: neoadjuvant therapy. In: Steele SR, Hull TL, Read TE, Saclarides TJ, Senagore AJ, Whitlow CB, eds. The ASCRS Textbook of Colon and Rectal Surgery. 3rd ed. New York: Springer; 2016:481-494.
  19. USA National İnstuties of Healty Guide for Grants and Contracts - Vol. 19, No. 28 - July 27, 1990.
  20. Rolf Sauer, Torsten Liersch, Susanne Merkel, Rainer Fietkau, Werner Hohenberger, Clemens Hess, Heinz Becker, Hans-Rudolf Raab, Marie Therese Villanueva, Helmut Witzigmann, Christian Wittekind, Tim Beissbarth, and Claus Rödel,Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731-1740.
  21. Smith FM, Wiland H, Mace A, Pai RK, Kalady MF. Clinical criteria underestimate complete pathological response in rec tal cancer treated with neoadjuvant chemoradiotherapy. Dis Colon Rectum. 2014;57(3):311-315.
  22. Sammour T, Price BA, Krause KJ, Chang GJ. Nonoperative management of “watch and wait” for rectal cancer with com plete clinical response after neoadjuvant chemoradiotherapy: a critical appraisal. Ann Surg Oncol. 2017;24:1904-1915. doi: 10.1245/s10434-017-5841-3.
  23. Habr-Gama A, Perez RO, Nadalin W, Sabbaga J, Ribeiro U, Silva e Sousa AH, Campos FG, Kiss DR, Gama-Rodrigues J. Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results. Ann Surg. 2004 Oct;240(4):711–7; discussion 717-718.
  24. Angelita Habr-Gama, Rodrigo O Perez, Gregory Wynn, John Marks, Hermann Kessler, Joaquim Gama-Rodrigues.Complete clinical response after neoadjuvant chemoradiation therapy for distal rectal cancer: characterization of clinical and endoscopic findings for standardization. Dis. Colon Rectum 53, 1692–1698 (2010).
  25. Angelita Habr-Gama, Guilherme Pagin São Julião, Bruna Borba Vailati, Jorge Sabbaga, Patricia Bailão Aguilar, Laura Melina Fernandez, Sergio Eduardo Alonso Araújo, Rodrigo Oliva Perez, Organ preservation in cT2N0 rectal cancer after neoadjuvant chemoradiation therapy: the impact of radiation therapy dose-escalation and consolidation chemotherapy. Ann. Surg. 269, 102–107 (2019).
  26. Påhlman L, Bohe M, Cedermark B, Dahlberg M, Lindmark G, Sjödahl R, Öjerskog B, Damber L, Johansson R. The Swedish rectal cancer registry. Br J Surg. 2007 Oct 1;94(10):1285–92.
  27. Dulk M den, Putter H, Collette L, Marijnen CAM, Folkesson J, Bosset JF, Rödel C, Bujko K, Påhlman L, Velde CJH van de. The abdominoperineal resection itself is associated with an adverse outcome: The European experience based on a pooled analysis of five European randomised clinical trials on rectal cancer. Eur J Cancer. 2009 May 1;45(7):1175–83.
  28. Lujan J, Valero G, Biondo S, Espin E, Parrilla P, Ortiz H. Laparoscopic versus open surgery for rectal cancer: results of a prospective multicentre analysis of 4,970 case. Surg Endosc. 2013 Jan 1;27(1):295–302.
  29. College of American Pathologists (CAP). Protocol for the Examination of Specimens from Case with Primary Carcinoma of the Colon and Rectum. Based on AJCC/UICC TNM, 7th edition. ColonRectum 3.1.0.0 cap.org http://webapps.cap. org/apps/ docs/committees/cancer/cancer_protocols/2009/ Colon_09protocol.pdf (2011).
  30. Royal College of Pathologists. Standards and datasets for reporting cancers. Dataset for histopathological reporting of colorectal cancer. 2017. https://www.rcpath.org/uploads/ assets/c8b61ba0- ae3f-43f1-85ffd3ab9f17cfe6/G049-dataset- forhistopathological-reporting-of-colorectal-cancer.pdf.
  31. Julio Garcia-Aguilar, Qian Shi, Charles R Thomas Jr, Emily Chan, Peter Cataldo, Jorge Marcet, David Medich, Alessio Pigazzi, Samuel Oommen, Mitchell C Posner. A phase II trial of neoadjuvant chemoradiation and local excision for T2N0 rectal cancer: preliminary results of the ACOSOG Z6041 trial. Ann Surg Oncol. 2012;19:384-391.
  32. Long-Term Survival After Transanal Excision of T1 Rectal Can.: Diseases of the Colon & Rectum [Internet]. [cited 2024 Jan 7]. Available from: https://journals.lww.com/dcrjournal/abstract/ 2009/04000/long_term_survival_after_transanal_excision_ of_t1.4.aspx
  33. Zhifei Sun, Mohamed A Adam, Jina Kim, Daniel P Nussbaum, Ehsan Benrashid, Christopher R Mantyh, John Migaly Determining the optimal timing for initiation of adjuvant chemotherapy after resection for Stage II and III colon cancer. Dis Colon Rectum. 2016;59(2):87-93.
  34. Rolf Sauer, Torsten Liersch, Susanne Merkel, Rainer Fietkau, Werner Hohenberger, Clemens Hess, Heinz Becker, Hans-Rudolf Raab, Marie Therese Villanueva, Helmut Witzigmann, Christian Wittekind, Tim Beissbarth, and Claus Rödel,Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004;351:1731-1740.
  35. Angelita Habr-Gama, Rodrigo O Perez, Gregory Wynn, John Marks, Hermann Kessler, Joaquim Gama-Rodrigues.Complete clinical response after neoadjuvant chemoradiation therapy for distal rectal cancer: characterization of clinical and endoscopic findings for standardization. Dis. Colon Rectum 53, 1692–1698 (2010).
  36. Angelita Habr-Gama, Guilherme Pagin São Julião, Bruna Borba Vailati, Jorge Sabbaga, Patricia Bailão Aguilar, Laura Melina Fernandez, Sergio Eduardo Alonso Araújo, Rodrigo Oliva Perez, Organ preservation in cT2N0 rectal cancer after neoadjuvant chemoradiation therapy: the impact of radiation therapy dose-escalation and consolidation chemotherapy. Ann. Surg. 269, 102–107 (2019).