This preprint is under consideration at World Journal of Surgical Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Michal Jankowski
Uniwersytet Mikolaja Kopernika Collegium Medicum
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9982-842X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Rectal cancer, one of most common neoplasms, is characterized by an overall survival rate exceeding 60%. Nonetheless, local recurrence (LR) following surgery for rectal cancer remains a formidable clinical problem. The aim of this study was to assess the value of postoperative endoscopic surveillance (PES) for the early detection of LR in rectal cancer after radical treatment.
Methods: We performed an anterior resection in 228 patients with stage I-III rectal cancer who had undergone surgery from 2001 to 2008 in the Oncology Center in Bydgoszcz, Poland. Of these patients, 169 had perioperative radiotherapy or radiochemotherapy. All patients underwent PES with imaging (abdominal ultrasound or computed tomography scan, pelvic magnetic resonance imaging) and endoscopic examinations. The ratios of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and receiver operating characteristic curve were calculated to compare the diagnostic value of colonoscopy versus imaging techniques.
Results: During the 5-year follow-up, recurrences occurred in 49 (21%) patients; of these, 15 (6%) had LR, which was most often located outside the intestinal lumen (n = 10, 4%). Anastomotic LR occurred in 5 (2%) patients. The mean time to anastomotic LR was 30 months after initial surgery, similar to that of other locations (29 months). Both imaging and endoscopy were shown to be efficient techniques for the diagnosis of LR in anastomotic sites, and endoscopy did not provide any additional benefit in patients who were receiving radiation therapy.
Conclusions: The benefit of PES for the detection of LR after curative treatment of rectal cancer is limited. It remains a useful method, however, for the histopathological confirmation of suspected or confirmed recurrence.
Keywords
surveillance after radical surgery, rectal cancer, local recurrence, endoscopy, imaging
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CURRENT STATUS: Under Review
Version (no preprint)
Posted 18 Apr, 2021
Editorial decision: Major Revision
On 18 Apr, 2021
Review #7 received
Received 12 Apr, 2021
Review #2 received
Received 10 Apr, 2021
Reviewer #8 agreed
On 09 Apr, 2021
Review #8 received
Received 09 Apr, 2021
Reviewer #7 agreed
On 06 Apr, 2021
Reviewer #4 agreed
On 05 Apr, 2021
Reviewer #5 agreed
On 05 Apr, 2021
Reviewer #6 agreed
On 05 Apr, 2021
Reviewer #3 agreed
On 05 Apr, 2021
Review #1 received
Received 05 Apr, 2021
Review #5 received
Received 05 Apr, 2021
Review #3 received
Received 05 Apr, 2021
Review #4 received
Received 05 Apr, 2021
Review #6 received
Received 05 Apr, 2021
Reviewer #2 agreed
On 04 Apr, 2021
Editor assigned
On 04 Apr, 2021
Reviewers invited
Invitations sent on 04 Apr, 2021
Reviewer #1 agreed
On 04 Apr, 2021
Submission checks complete
On 04 Apr, 2021
Editor invited
On 04 Apr, 2021
This version was not preprinted
Version (no preprint)
Posted 11 Apr, 2021
Reviewers invited
Invitations sent on 11 Apr, 2021
Reviews received
Received 05 Apr, 2021
First submitted
On 03 Apr, 2021
This version was not preprinted
Version 1
Posted 01 Feb, 2021
No community comments so far
Editorial decision: Major Revision
On 17 Feb, 2021
Review #7 received
Received 28 Jan, 2021
Reviewer #10 agreed
On 28 Jan, 2021
Review #3 received
Received 28 Jan, 2021
Review #1 received
Received 28 Jan, 2021
Review #5 received
Received 28 Jan, 2021
Review #8 received
Received 26 Jan, 2021
Reviewer #9 agreed
On 26 Jan, 2021
Review #4 received
Received 26 Jan, 2021
Review #6 received
Received 26 Jan, 2021
Reviewer #2 agreed
On 25 Jan, 2021
Reviewer #3 agreed
On 25 Jan, 2021
Reviewer #4 agreed
On 25 Jan, 2021
Reviewer #5 agreed
On 25 Jan, 2021
Reviewer #6 agreed
On 25 Jan, 2021
Reviewer #7 agreed
On 25 Jan, 2021
Reviewer #8 agreed
On 25 Jan, 2021
Editor assigned
On 25 Jan, 2021
Reviewers invited
Invitations sent on 25 Jan, 2021
Reviewer #1 agreed
On 25 Jan, 2021
Review #2 received
Received 25 Jan, 2021
Submission checks complete
On 25 Jan, 2021
Editor invited
On 25 Jan, 2021
First submitted
On 23 Jan, 2021
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This preprint is under consideration at World Journal of Surgical Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Michal Jankowski
Uniwersytet Mikolaja Kopernika Collegium Medicum
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9982-842X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version (no preprint)
Posted 18 Apr, 2021
Editorial decision: Major Revision
On 18 Apr, 2021
Review #7 received
Received 12 Apr, 2021
Review #2 received
Received 10 Apr, 2021
Reviewer #8 agreed
On 09 Apr, 2021
Review #8 received
Received 09 Apr, 2021
Reviewer #7 agreed
On 06 Apr, 2021
Reviewer #4 agreed
On 05 Apr, 2021
Reviewer #5 agreed
On 05 Apr, 2021
Reviewer #6 agreed
On 05 Apr, 2021
Reviewer #3 agreed
On 05 Apr, 2021
Review #1 received
Received 05 Apr, 2021
Review #5 received
Received 05 Apr, 2021
Review #3 received
Received 05 Apr, 2021
Review #4 received
Received 05 Apr, 2021
Review #6 received
Received 05 Apr, 2021
Reviewer #2 agreed
On 04 Apr, 2021
Editor assigned
On 04 Apr, 2021
Reviewers invited
Invitations sent on 04 Apr, 2021
Reviewer #1 agreed
On 04 Apr, 2021
Submission checks complete
On 04 Apr, 2021
Editor invited
On 04 Apr, 2021
This version was not preprinted
Version (no preprint)
Posted 11 Apr, 2021
Reviewers invited
Invitations sent on 11 Apr, 2021
Reviews received
Received 05 Apr, 2021
First submitted
On 03 Apr, 2021
This version was not preprinted
Version 1
Posted 01 Feb, 2021
No community comments so far
Editorial decision: Major Revision
On 17 Feb, 2021
Review #7 received
Received 28 Jan, 2021
Reviewer #10 agreed
On 28 Jan, 2021
Review #3 received
Received 28 Jan, 2021
Review #1 received
Received 28 Jan, 2021
Review #5 received
Received 28 Jan, 2021
Review #8 received
Received 26 Jan, 2021
Reviewer #9 agreed
On 26 Jan, 2021
Review #4 received
Received 26 Jan, 2021
Review #6 received
Received 26 Jan, 2021
Reviewer #2 agreed
On 25 Jan, 2021
Reviewer #3 agreed
On 25 Jan, 2021
Reviewer #4 agreed
On 25 Jan, 2021
Reviewer #5 agreed
On 25 Jan, 2021
Reviewer #6 agreed
On 25 Jan, 2021
Reviewer #7 agreed
On 25 Jan, 2021
Reviewer #8 agreed
On 25 Jan, 2021
Editor assigned
On 25 Jan, 2021
Reviewers invited
Invitations sent on 25 Jan, 2021
Reviewer #1 agreed
On 25 Jan, 2021
Review #2 received
Received 25 Jan, 2021
Submission checks complete
On 25 Jan, 2021
Editor invited
On 25 Jan, 2021
First submitted
On 23 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Rectal cancer, one of most common neoplasms, is characterized by an overall survival rate exceeding 60%. Nonetheless, local recurrence (LR) following surgery for rectal cancer remains a formidable clinical problem. The aim of this study was to assess the value of postoperative endoscopic surveillance (PES) for the early detection of LR in rectal cancer after radical treatment.
Methods: We performed an anterior resection in 228 patients with stage I-III rectal cancer who had undergone surgery from 2001 to 2008 in the Oncology Center in Bydgoszcz, Poland. Of these patients, 169 had perioperative radiotherapy or radiochemotherapy. All patients underwent PES with imaging (abdominal ultrasound or computed tomography scan, pelvic magnetic resonance imaging) and endoscopic examinations. The ratios of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and receiver operating characteristic curve were calculated to compare the diagnostic value of colonoscopy versus imaging techniques.
Results: During the 5-year follow-up, recurrences occurred in 49 (21%) patients; of these, 15 (6%) had LR, which was most often located outside the intestinal lumen (n = 10, 4%). Anastomotic LR occurred in 5 (2%) patients. The mean time to anastomotic LR was 30 months after initial surgery, similar to that of other locations (29 months). Both imaging and endoscopy were shown to be efficient techniques for the diagnosis of LR in anastomotic sites, and endoscopy did not provide any additional benefit in patients who were receiving radiation therapy.
Conclusions: The benefit of PES for the detection of LR after curative treatment of rectal cancer is limited. It remains a useful method, however, for the histopathological confirmation of suspected or confirmed recurrence.
Figure 1
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