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How do you manage local/mesenteric lymph node recurrence of colon cancer after surgery and adjuvant therapy?

Would you approach with curative intent with locoregional treatment or systemic treatment alone?
5 Answers
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Medical Oncology · Siri Onclogy and hematology Infusion Service
Answered on

The concern is that, as mentioned, that this man has peritoneal recurrences. This would be particularly true if the tumor is mucinous. Chemotherapy trials have not been abundant in patients with peritoneal metastases, and suggestions are that they are not as sensitive to chemotherapy.

My recommendat...

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Medical Oncology · Yale Cancer Center At Smilow Cancer Hospital
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Management of oligometastic colorectal cancer is a frequently encountered clinical problem. The success of local therapy for liver metastases has been well studied, with survival rates as high as 25% at 10 years for this population (Kanas GP, et al, 2012). The value of this approach has been extrapo...

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Medical Oncology · Florida Cancer Specialists
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What was time frame? Early or late relapse? Was a PET and/or MRI abd done to confirm no other sites of disease? If positive, then unresectable and treatment is palliative and would do chemo (if rapid recurrence would be inclined to switch to FOLFIRI assuming adjuvant was FOLFOX and not just 5-FU) + ...

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Medical Oncology · Jefferson Kimmel Cancer Center
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I agree with the crux of the responses.

Local only recurrences in colorectal cancer are rare but tend to be associated with poor prognosis. For this reason, starting with chemotherapy makes sense with the potential to pursue additional surgery if disease remains limited over time with further invest...

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Radiation Oncology · Radiotherapy Cancer Center (RTCC)
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Would you consider SBRT or radiotherapy for consolidation (instead of surgery) if only partial response to chemotherapy and PET CT does not show any other site of disease except local site?

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