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- Waldenstedt, Sophia, et al.
(författare)
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Intraoperative adverse events as a risk factor for local recurrence of rectal cancer after resection surgery.
- 2022
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Ingår i: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. - : Wiley. - 1463-1318. ; 24:4, s. 449-460
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Tidskriftsartikel (refereegranskat)abstract
- Failure to achieve a radical resection as well as intraoperative rectal perforation are important risk factors for local recurrence after rectal cancer surgery, but the importance of other intraoperative adverse events for the prognosis is unknown. The aim of this study was to assess the occurrence of intraoperative adverse events during rectal cancer surgery, and to determine whether these were associated with an increased risk of local recurrence.A retrospective population-based cohort study was undertaken, including all patients in Region Västra Götaland, Sweden, who had undergone primary resection surgery for rectal cancer diagnosed between 2010 and 2014, registered in the Swedish Colorectal Cancer Registry. Data were retrieved from the registry and through review of the medical records.In total 1208 patients were included, of whom 78 (6%) developed local recurrence during the follow-up period of at least 5 years. Intraoperative adverse events were common and occurred in 62/78 (79%) of patients with local recurrence compared to 604/1130 (53%) of patients without local recurrence. In multivariate analysis intraoperative adverse events were found to be an independent risk factor for local recurrence of rectal cancer, as were non-radical resection, a high pathological T-stage, the presence of lymph node metastases, type of surgery and refraining from rectal washout during anterior resection and Hartmann´s procedure.Intraoperative adverse events were found to be an independent risk factor for local recurrence of rectal cancer and could possibly be used together with other known risk factors to select patients for intensified postoperative surveillance.
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| 2. |
- Waldenstedt, Sophia, et al.
(författare)
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Symptoms and diagnosis of local recurrence after rectal cancer treatment
- 2022
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 61:9, s. 1043-1049
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Tidskriftsartikel (refereegranskat)abstract
- Aim The prognosis for local recurrence after rectal cancer treatment is poor. A minority of patients are eligible for surgery with curative intent, which could possibly be improved by earlier detection. The aim of this study was to determine symptoms at presentation and how local recurrence was diagnosed, and to identify alarm symptoms for local recurrence as opposed to symptoms found among patients after surgery for rectal cancer in general. Methods In a population-based retrospective cohort (cohort A), all patients who had undergone resection surgery for rectal cancer in the region of Vastra Gotaland, Sweden, diagnosed 2010-2014, were identified through the Swedish ColoRectal Cancer Registry. After a follow-up period of at least five years, medical records were reviewed to identify patients diagnosed with local recurrence. Data on symptoms, diagnostic procedures and treatment of local recurrence were retrieved. A prospective cohort of patients who had undergone surgery for rectal cancer without local recurrence (the QoLiRECT-study, cohort B) was used for comparison regarding symptoms at two years after treatment. Results Cohort A consisted of 1208 patients, out of whom 78 (6%) were diagnosed with local recurrence. Forty-six patients were diagnosed between scheduled follow-up visits. Fifty-eight patients were symptomatic at the time of diagnosis, and the most common symptoms were pain, bleeding and urogenital symptoms. Pain was more common in patients with local recurrence when comparing cohort A with cohort B. Conclusion A majority of patients with local recurrence were diagnosed outside of the scheduled follow-up. Most of the patients were symptomatic at diagnosis. Symptoms were common in patients after rectal cancer surgery in general, however pain was more common in patients with local recurrence and could represent an alarm symptom.
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