Incidence and patterns of late recurrences in rectal cancer patients.

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Date publication

février 2015

Auteurs

Membres identifiés du Cancéropôle Est :
Pr BEDENNE Laurent, Dr BOUVIER Anne-Marie, Dr JOOSTE Valérie, Dr COTTET Vanessa


Tous les auteurs :
Cottet V, Bouvier V, Rollot F, Jooste V, Bedenne L, Faivre J, Launoy G, Bouvier AM

Résumé

BACKGROUND: Long-term recurrences of rectal cancer raised questions about the possible benefit of prolonging the recommended active 5-year clinical and endoscopic surveillance. The aim of this study was to determine for the first time, incidence and patterns of late 10-year recurrence after curative resection of rectal cancer. METHODS: The study included 1,222 patients with rectal cancer resected for cure between 1985 and 2000 from those registered in two French population-based digestive cancer registries. Information about local recurrences and distant metastases at 10 years was retrospectively and actively collected up to January 1, 2011. RESULTS: Although the overall 5-year cumulated rate was 39.5 %, the 10-year cumulated rate was 44.1 % (25.6 % for local recurrence and 29.9 % for distant metastases). In multivariate analyses, TNM stage was associated with a higher risk of local recurrence (hazard ratio [HR] stage III vs. stage I = 3.98 [95 % confidence interval, 2.66-5.94]) and of distant metastasis (HR = 3.60 [2.65-4.91]). Preoperative radiotherapy decreased the risk of local recurrence (HR = 0.43 [0.28-0.66]), but not the risk of metastasis. Patients diagnosed between 1995 and 2000 were less prone to develop long-term metastasis than those diagnosed between 1985 and 1989 (HR = 0.66 [0.49-0.88]). Among patients without recurrence 5 years after diagnosis, one patient in 13 developed a recurrence between 5 and 10 years. CONCLUSIONS: Late recurrences do exist. A personalised surveillance could be extended until 10 years according to the characteristics of primary tumour and the patient.

Référence

Ann Surg Oncol. 2015 Feb;22(2):520-7