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

Area of Science:

• Oncology
• Surgical Oncology
• Radiotherapy

Background:

• Neoadjuvant radiochemotherapy (RCT) and total neoadjuvant therapy (TNT) have significantly improved local recurrence rates in rectal cancer compared to total mesorectal excision (TME) alone.
• Late local recurrences occurring many years after initial treatment represent a distinct clinical challenge.

Purpose of the Study:

• To investigate the occurrence and characteristics of late local recurrences in rectal cancer patients treated with neoadjuvant therapy and radical resection.
• To determine if neoadjuvant therapy influences the timing of local recurrence.

Main Methods:

• Retrospective analysis of 188 rectal cancer patients who received neoadjuvant therapy (RCT) followed by radical resection.
• Identification and characterization of patients who experienced local recurrence, with a focus on the timing of recurrence.

Main Results:

• Of 188 patients, 38 (20.2%) experienced recurrence. 68% of recurrences developed within the first two years post-surgery.
• Four patients (10% of recurrent cases) experienced late local recurrence more than 8 years after surgery.
• These late recurrences suggest a potential delay in local recurrence due to neoadjuvant therapy.

Conclusions:

• While neoadjuvant therapy effectively reduces early local recurrences in rectal cancer, late recurrences can occur.
• The occurrence of late local recurrences, even after many years, highlights the need for long-term surveillance.
• Neoadjuvant therapy may play a role in delaying the onset of local recurrence in rectal cancer.