Surgical Treatment and Molecular Marker Exploration of Locally Recurrent Colorectal Cancer

Trial Title: Surgical Treatment and Molecular Marker Exploration of Locally Recurrent Colorectal Cancer

NCT ID: NCT06114420

Condition: Locally Recurrent Colorectal Cancer

Conditions: Official terms:
Colorectal Neoplasms
Recurrence

Study type: Observational

Overall status: Recruiting

Study design:

Time perspective: Prospective

Intervention:

Intervention type: Procedure
Intervention name: salvage surgery
Description: Some patients who cannot undergo surgery
Arm group label: patients with local recurrence

Other name: adjuvant treatment

Summary: This study intends to explore the clinicopathological characteristics and survival prognosis of locally recurrent colorectal cancer patients with different treatment modes by retrospectively analyzing the medical records of locally recurrent colorectal cancer patients who received hospitalization in our center. Transcriptome sequencing and public databases were used to screen for molecular markers related to locally recurrent colorectal cancer and to explore molecular markers' regulatory role in the progression of locally recurrent colorectal cancer.

Detailed description: In the past few decades, although the widespread implementation of total mesorectal excision (TME) and neoadjuvant chemoradiotherapy has dramatically reduced the postoperative local recurrence rate of rectal cancer, local recurrence after radical resection of colorectal cancer still affects the long-term survival of patients. One of the main reasons is that the postoperative local recurrence rate in patients with rectal cancer is about 6-10%, while that in colon cancer is about 4-13%. In clinical practice, surgical treatment is the preferred treatment option for patients with locally recurrent colorectal cancer (LRCRC). However, only more than one-third of LRCRC patients can be surgically resected with recurrent lesions. For surgically treatable LRCRC patients, since the recurrent lesions often infiltrate widely, complete resection of the lesions usually requires expanding the scope of surgical resection, and posterior pelvic surgery is needed if necessary. Surgery (PPE) or even total pelvic excision (TPE), the complications, functional impairment, and perioperative death caused by the surgery also affect the patient's near and far prognosis. When there are distant metastases or unresectable recurrent tumors, radical resection is often not feasible, which may result in significant morbidity and mortality, so it is necessary to explore different treatment modalities, especially surgical treatment. What is the impact on LRCRC. The mechanism of local recurrence is usually thought to be caused by insufficient resection margins or the planting of detached tumor cells. Another standard theory is that it is caused by metachronous canceration around the anastomosis.The possible reasons are unstable cell proliferation and epithelial adaptation at the anastomosis site-sexual hyperplasia. Some studies also believe neither theory can explain the higher recurrence rate around the anastomosis, suggesting that it may be due to unique and persistent genetic changes. By reading a large amount of relevant literature, we found that local recurrence is a kind of metastasis or metachronous metastasis. Metastasis is a complex, multi-step process. Current metastasis research mainly focuses on various cancer cells. However, research on the molecular regulatory mechanisms of colorectal cancer metastasis is still limited.

Criteria for eligibility:

Study pop:
Patients with locally recurrent colorectal cancer who underwent surgery during hospitalization and whose primary surgical pathology was stage II/III.

Sampling method: Non-Probability Sample
Criteria:
Inclusion Criteria: 1. Patients with LRCRC who received hospitalization in our center and patients with stage II-III colorectal cancer whose primary surgery was radical surgery 2. The pathological type of primary tumor is adenocarcinoma 3. Postoperative local recurrence of colorectal cancer diagnosed by imaging or pathological examination 4. Have complete medical records and continuous follow-up records Exclusion Criteria: 1. Familial hereditary colorectal malignant tumors 2. Past history of other malignant tumors 3. Recurrence and diffuse peritoneal recurrence occurring within 1 month after surgery

Gender: All

Minimum age: 18 Years

Maximum age: 85 Years

Healthy volunteers: No

Locations:

Facility:
Name: Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College

Address:
City: Beijing
Zip: 100021
Country: China

Status: Recruiting

Contact:
Last name: Zhaoxu Zheng, M.D.

Phone: 86-010-87787110
Email: zzx_20003@126.com

Contact backup:
Last name: Fei Huang, M.D.

Phone: 86-010-87787670
Email: frankhuangxm@outlook.com

Start date: January 30, 2023

Completion date: December 31, 2025

Lead sponsor:
Agency: Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Agency class: Other

Source: Cancer Institute and Hospital, Chinese Academy of Medical Sciences

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06114420