Al Haidari Ghazwan, Solbakken Arne M, Åsli Linn Merete, Skovlund Eva, Undseth Christine, Guren Marianne Grønlie
Department of Oncology, Oslo University Hospital, Oslo, Norway.
Section of Abdominal Cancer Surgery, Department of Surgical Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
Acta Oncol. 2025 Jun 11;64:784-792. doi: 10.2340/1651-226X.2025.42991.
The rate of locally recurrent rectal cancer (LRRC) in Norway has decreased due to advancements in surgical techniques and preoperative treatments. Despite this, LRRC continues to present significant morbidity and mortality challenges. This study aims to analyze survival outcomes following different treatment modalities for LRRC in Norway and assess the impact of changes in treatment strategies over time.
This retrospective study utilized data from the Cancer Registry of Norway, focusing on patients with stage I-III primary rectal cancer treated between 1997 and 2016, who subsequently developed LRRC. Treatment modalities, including surgery, radiotherapy (RT), and re-irradiation (reRT), were analyzed, and the impact of various factors on overall survival (OS) was assessed.
Of the 13,480 patients who underwent surgery for rectal cancer, 827 (6.1%) developed LRRC. For all patients, the median survival from LRRC diagnosis was 18 months, with a 3-year OS of 29%. For patients who underwent surgical resection of LRRC, the 3-year OS was 55% for those who received pre-operative RT, 50% for those who received reRT, and 35% for those without any radiation therapy. For non-operated patients, 3-year OS rates were 22% with RT, 21% with reRT, and 15% for patients without radiation therapy. Patients diagnosed after 2006, patients with early-stage primary cancer, younger age (<75), extended recurrence interval, or well-differentiated tumors had better survival outcomes.
This study describes the outcomes after multimodal treatment approaches for LRRC on a national level over a 20-year period. Patients who underwent surgical resection combined with RT or reRT had the best survival outcomes; however, this group represents a highly selected patient population.
由于手术技术和术前治疗的进步，挪威局部复发性直肠癌（LRRC）的发生率有所下降。尽管如此，LRRC仍然带来了重大的发病率和死亡率挑战。本研究旨在分析挪威LRRC不同治疗方式后的生存结果，并评估治疗策略随时间变化的影响。
这项回顾性研究利用了挪威癌症登记处的数据，重点关注1997年至2016年间接受I - III期原发性直肠癌治疗后发生LRRC的患者。分析了包括手术、放疗（RT）和再放疗（reRT）在内的治疗方式，并评估了各种因素对总生存期（OS）的影响。
在13480例接受直肠癌手术的患者中，827例（6.1%）发生了LRRC。所有患者从LRRC诊断后的中位生存期为18个月，3年总生存率为29%。对于接受LRRC手术切除的患者，术前接受放疗的患者3年总生存率为55%，接受再放疗的患者为50%，未接受任何放疗的患者为35%。对于未手术的患者，放疗患者的3年总生存率为22%，再放疗患者为21%，未接受放疗的患者为15%。2006年后诊断的患者、早期原发性癌症患者、年龄较小（<75岁）、复发间隔延长或肿瘤分化良好的患者生存结果较好。
本研究描述了20年间全国范围内LRRC多模式治疗方法后的结果。接受手术切除联合放疗或再放疗的患者生存结果最佳；然而，这组患者是经过高度筛选的人群。
