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International Journal of Colorectal Disease

, Volume 33, Issue 11, pp 1533–1541 | Cite as

Repeating of local therapy of distant metastases increases overall survival in patients with synchronous metastasized rectal cancer—a monocentric analysis

  • Marlen Haderlein
  • Sebastian Lettmaier
  • Melanie Langheinrich
  • Axel Schmid
  • Sabine Semrau
  • Markus Hecht
  • Michael Beck
  • Daniela Schmidt
  • Robert Grützmann
  • Rainer Fietkau
  • Axel Denz
Original Article
  • 99 Downloads

Abstract

Purpose

The aim was to evaluate the outcome of treatment-naive patients with synchronous metastatic rectal cancer after chemotherapy with FOLFOXIRI followed by local therapeutic procedures of all tumor lesions as complete as possible.

Methods

We reviewed data of 30 patients with synchronous distant metastatic rectal cancer who underwent chemotherapy with FOLFOXIRI and subsequent local therapy in our institution.

Results

Median follow-up was 28 months (range: 8; 74). Cumulative overall survival (OS) and progression-free survival (PFS) was 93.3, 76.9, 55.6% and 46.2, 29.7, 29.7% after 1, 2, 4 years. Non-response to chemotherapy with FOLFOXIRI was associated with a highly significant decreased OS (p < 0.0001). The consistent use of local ablative procedures led to a statistically significant increase in OS (p < 0.0001), but not in PFS (p = 0.635). Patients with ≤ 4 distant metastases showed a better OS (p = 0.033).

Conclusions

Response to intensified first-line chemotherapy with FOLFOXIRI, treatment of the primary rectal tumor, and repeated thorough local ablative procedures in patients with synchronous metastasized rectal cancer may lead to long-term survival, even in a subset of patients with unresectable disease at initial diagnosis.

Keywords

Rectal cancer Synchronous distant metastases FOLFOXIRI Local ablative procedures 

Notes

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement of informed consent

For this retrospective type of study, formal consent is not required.

Supplementary material

384_2018_3113_MOESM1_ESM.docx (25 kb)
ESM 1 (DOCX 24 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Marlen Haderlein
    • 1
  • Sebastian Lettmaier
    • 1
  • Melanie Langheinrich
    • 2
  • Axel Schmid
    • 3
  • Sabine Semrau
    • 1
  • Markus Hecht
    • 1
  • Michael Beck
    • 4
  • Daniela Schmidt
    • 4
  • Robert Grützmann
    • 2
  • Rainer Fietkau
    • 1
  • Axel Denz
    • 2
  1. 1.Department of Radiation OncologyUniversity Hospital of ErlangenErlangenGermany
  2. 2.Department of SurgeryUniversity Hospital of ErlangenErlangenGermany
  3. 3.Department of RadiologyUniversity Hospital of ErlangenErlangenGermany
  4. 4.Department of Nuclear MedicineUniversity Hospital of ErlangenErlangenGermany

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