All patients with recurrent colorectal cancer in the pelvis are eligible. The original primary tumour staging scans and resected surgical specimen needs to be available. Patients' recurrence will be staged using our proposed MRI classification. We will be assessing the original primary staging scans and histopathology to learn about risk factors for recurrence. We will record treatment for the recurrence, and patients will be followed up for three years.
A prospective and retrospective cohort study to improve surgical and treatment planning using an imaging assessment proforma of advanced and recurrent colorectal cancers. This involves the implementation of imaging assessment proformas describing anatomic pelvic compartments and aetiology of disease recurrence for treatment planning.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
383
Currently there are no validated criteria or guidelines for judging whether advanced primary or recurrent colorectal cancer can be successfully removed and for selecting which patients should undergo this form of more radical surgery as is exenterative surgery. We are proposing that by validating the detailed evaluation of imaging of the tumour distribution within the pelvis using a new radiological staging classification, this will enable clear selection criteria to be established and will improve surgical planning.
Oslo University Hospital
Oslo, Norway
RECRUITINGSt Mark's Hospital
Harrow, London, United Kingdom
RECRUITINGChurchill Hospital
Oxford, Oxfordshire, United Kingdom
RECRUITINGTo change R0 resection rates for locally recurrent rectal cancers with the use of the proposed staging system.
An increase of 20% in R0 resection (from 55% to 75%) for locally recurrent rectal cancers with the use of the proposed staging system
Time frame: 3 years
To compare baseline prognostic features against type of recurrence
Correlation of baseline and post treatment prognostic factors on imaging and pathology against type of recurrence.
Time frame: 3 and 5 years
To compare the MRI type of recurrence against clinical outcomes
Proportion of patients with survival \>12mths according to type of recurrence as described on MRI
Time frame: 1, 3 and 5 years
To compare the MRI compartment(s) distribution of recurrence against clinical outcomes
Proportion of patients with survival \>12mths according to compartment(s) of recurrence as described on MRI
Time frame: 1, 3 and 5 years
To investigate the effect of surgical and non-surgical treatments for recurrence on Quality of Life
Quality of life assessed using EORTC QLQ-C30
Time frame: 1, 2, 3 and 5 years
To compare radiology and histopathology compartments in patients undergoing beyond TME surgery for recurrence
The number of compartments predicted as involved on MRI against the number of compartments reported on the corresponding pathology specimens
Time frame: Up to 2 years
To measure radiology inter-observer agreement for types of recurrence classification
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Royal Marsden Hospital NHS Foundation Trust
Sutton, United Kingdom
RECRUITINGKappa agreement between paired radiologists for type of recurrence
Time frame: 5 years
To investigate health economic costs of patients with pelvic recurrence against type
Healthcare costs using NHS Reference Costs combined with health resource utilization and QoL data
Time frame: Up to 3 years
To map original radiotherapy volumes (including integrated boosts) against types of recurrence
Correlation of dose, type and distribution of radiotherapy against anatomic sites and aetiology of recurrence as seen on MRI
Time frame: Up to 2 years