Symptoms and diagnosis of local recurrence after rectal cancer treatment

Figures & data

Figure 1. Flowchart cohort A. 

Figure 2. Flowchart cohort B. 

Table 1. Diagnosis and management of local recurrence (Cohort A).

	Local recurrence n = 78
Diagnosed at follow-up
Yes	32
No^a	46
Symptomatic at diagnosis
Yes	58
No	20
Duration of symptoms^b	(n = 58)
<1 month	9
1-3 months	16
3-6 months	5
>6 months	5
Indeterminate	23
Time to local recurrence (months)
Median	21
IQR	11–35
Range	1–99
Diagnostic modality^c
Clinical examination	28
Recto-/colonoscopy	16
Cystoscopy	4
Radiology^d	72
Surgical exploration	5
Distant metastasis at diagnosis of local recurrence
Yes	39
Multidisciplinary team conference
Yes	54
Curative intention	(n = 16)
Multidisciplinary team conference
Yes	15
Surgical approach
Total pelvic excentration	6
Colorectum + other organ	2
Colorectum only	3
Other organ(s) only	1
Local excision	1
No resection^e	3
Chemo- and/or radiotherapy
Yes	12
Microscopically radical resections of surgical procedures	(n = 13)
Yes	7
No	3
Uncertain	2
Missing	1
Palliativ intention	(n = 62)
Multidisciplinary team conference
Yes	39
Treatment^f
Surgery	20
Chemo- and/or radiotherpy	34
Best supportive care	16
Surgical approach	(n = 20)
Tumour resection	1
Small bowel resection (with anastomosis)	2
Stoma	6
Intestinal bypass	11

^aDiagnosed between scheduled follow-up visits.

^bAnalysed only for patients with symptoms at diagnosis.

^cOnly modalities that had findings indicating local recurrence are reported. More than one diagnostic modality could be used for each patient.

^dCT = 25 (32%), MRI = 24 (31%) CT + MR = 7 (9%), CT/MRI + PET = 12 (15%), PET = 4 (5%).

^eSurgery was terminated without tumour resection due to extensive tumour growth discovered intraoperatively.

^fOne patient could have more than one treatment option.

Figure 3. Symptoms at diagnosis of local recurrence, cohort A (one patient could have more than one symptom). 

Table 2. Outcome (Cohort A).

	Curative intent n = 16	Palliative intent n = 62
Local rerecurrence
Yes	4	—
No	9	—
Not resected	3	—
Distant metastasis
Yes, at diagnosis of local recurrence	1	38
Yes, after diagnosis of local recurrence	6	9
No	9	15
Surivival after diagnosis of local recurrence (months)
Median	37	10
Range	9-105	0-65

Data availability statement

The data supporting the findings of this study can be shared upon reasonable request by contacting the corresponding author (SW).