RT Journal Article
SR Electronic
T1 Cutaneous Stomal Recurrence of Colorectal Cancer After Curative Rectal Cancer Surgery – A Case Report and Systematic Review
JF In Vivo
JO In Vivo
FD International Institute of Anticancer Research
SP 2193
OP 2199
DO 10.21873/invivo.12029
VO 34
IS 5
A1 DAVEY, SIMON
A1 MCCARTHY, KATHRYN
YR 2020
UL http://iv.iiarjournals.org/content/34/5/2193.abstract
AB Background/Aim: Stomal metastases from a primary rectal adenocarcinoma are rare, therefore, clear guidelines on treatment options are limited. We performed a systematic review including a case report on this subject with the primary objective of identifying the total number of cases in the literature. The secondary objective was to assess median survival. Materials and Methods: A 59-year-old woman presented to our institution with anal incontinence to mucus leakage. Flexible sigmoidoscopy identified a carpet adenoma from the dentate line to the rectosigmoid junction. An abdomino-perineal resection (APR) was performed using the transanal total mesorectal excision technique (TaTME). No adjuvant chemotherapy was offered. Twenty-one months following the operation a stomal recurrence was identified. Palliative radiotherapy was commenced and the patient is alive 6 months later with no visible recurrence at the site of the stoma. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Results: The systematic review identified 19 individual cases of either metachronous or true metastatic recurrence, including our own case. Median survival was 30 months in the 8 cases where further treatment was offered and accepted. Conclusion: Stomal metastases or metachronous colorectal cancer is uncommon. The causes for this pattern of spread are not clear. Long-term survival from cutaneous recurrence is generally poor. For carefully selected patients, redo surgery is an option with satisfactory results.