{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:16:42Z","timestamp":1777918602916,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Locally recurrent rectal cancer is resected with clear margins in only 50% of cases, and these patients achieve a three-year survival rate of 50%. Outcomes and therapeutic strategies for nonresectable locally recurrent rectal cancer have been much less explored. The aim of the study was to assess the three-year progression-free survival and the three-year overall survival in locally recurrent rectal cancer patients treated by chemotherapy\/chemoradiation only vs. chemotherapy\/chemoradiation and R2 surgical debulking vs. palliative care. A total of 86 patients affected by nonresectable locally recurrent rectal cancer were included: three-year progression-free survival was 15.8% with chemotherapy\/chemoradiation vs. 20.3% with R2 surgical debulking (Log-rank p=0.567), but both rates were higher than best palliative care (0.0%, Log-rank p=0.0004). Three-year overall survival rates were respectively 62.0%, 70.8% and 0.0% (Log-rank p&lt;0.0001). Chemotherapy\/chemoradiation (HR 0.33, p=0.028) and R2 surgical debulking with or without chemotherapy\/chemoradiation (HR 0.23, p=0.005) were independent predictors of improved progression-free survival on multivariate analysis. In conclusion, both chemotherapy\/chemoradiation alone and R2 surgery with or without chemotherapy\/chemoradiation provide a survival benefit over palliative care in nonresectable locally recurrent rectal cancer. However, considering that pelvic debulking is burdened by a high rate of complications, and considering its negligible impact on progression-free survival and overall survival when associated to medical therapy, surgery should be avoided in this setting.<\/jats:p>","DOI":"10.1177\/03008916241253130","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T05:42:36Z","timestamp":1715319756000},"page":"360-365","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of chemotherapy\/chemoradiation vs. R2 surgical debulking vs. palliative care in nonresectable locally recurrent rectal cancer"],"prefix":"10.1177","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3963-2385","authenticated-orcid":false,"given":"Luca","family":"Sorrentino","sequence":"first","affiliation":[{"name":"Colorectal Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, 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