Treatment and outcomes for locally recurrent rectal cancer in Norway

Background: 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 followin...

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Main Authors: Ghazwan Al Haidari, Arne M. Solbakken, Linn Merete Åsli, Eva Skovlund, Christine Undseth, Marianne Grønlie Guren
Format: Article
Language:English
Published: Medical Journals Sweden 2025-06-01
Series:Acta Oncologica
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Online Access:https://medicaljournalssweden.se/actaoncologica/article/view/42991
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author Ghazwan Al Haidari
Arne M. Solbakken
Linn Merete Åsli
Eva Skovlund
Christine Undseth
Marianne Grønlie Guren
author_facet Ghazwan Al Haidari
Arne M. Solbakken
Linn Merete Åsli
Eva Skovlund
Christine Undseth
Marianne Grønlie Guren
author_sort Ghazwan Al Haidari
collection DOAJ
description Background: 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. Methods: 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. Results: 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. Interpretation: 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.
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spelling doaj-art-fd2071d2be8f417c8d18f78402ed44652025-08-20T02:33:00ZengMedical Journals SwedenActa Oncologica1651-226X2025-06-016410.2340/1651-226X.2025.42991Treatment and outcomes for locally recurrent rectal cancer in NorwayGhazwan Al Haidari0Arne M. Solbakken1Linn Merete Åsli2Eva Skovlund3Christine Undseth4Marianne Grønlie Guren5Department of Oncology, Oslo University Hospital, Oslo, NorwaySection of Abdominal Cancer Surgery, Department of Surgical Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, NorwayDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, NorwayBackground: 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. Methods: 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. Results: 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. Interpretation: 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. https://medicaljournalssweden.se/actaoncologica/article/view/42991Locally recurrent rectal cancersurgical resectionradiotherapyreirradiationoverall survivalmultimodal treatment
spellingShingle Ghazwan Al Haidari
Arne M. Solbakken
Linn Merete Åsli
Eva Skovlund
Christine Undseth
Marianne Grønlie Guren
Treatment and outcomes for locally recurrent rectal cancer in Norway
Acta Oncologica
Locally recurrent rectal cancer
surgical resection
radiotherapy
reirradiation
overall survival
multimodal treatment
title Treatment and outcomes for locally recurrent rectal cancer in Norway
title_full Treatment and outcomes for locally recurrent rectal cancer in Norway
title_fullStr Treatment and outcomes for locally recurrent rectal cancer in Norway
title_full_unstemmed Treatment and outcomes for locally recurrent rectal cancer in Norway
title_short Treatment and outcomes for locally recurrent rectal cancer in Norway
title_sort treatment and outcomes for locally recurrent rectal cancer in norway
topic Locally recurrent rectal cancer
surgical resection
radiotherapy
reirradiation
overall survival
multimodal treatment
url https://medicaljournalssweden.se/actaoncologica/article/view/42991
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