Carmo Silva M, Correia de Sá T, Pereira KP, Pisco JM. Predicting early recurrence in resectable rectal cancer. World J Gastrointest Surg 2025; 17(8): 101227 [DOI: 10.4240/wjgs.v17.i8.101227]
Corresponding Author of This Article
Manuel Carmo Silva, MD, Doctor, Department of Radiotherapy, ULS Santa Maria, Av. Prof. Egas Moniz MB, Lisbon 1649-028, Portugal. mj.oliveiracampos@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2025; 17(8): 101227 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.101227
Predicting early recurrence in resectable rectal cancer
Manuel Carmo Silva, Tiago Correia de Sá, Kayla P Pereira, Joana M Pisco
Manuel Carmo Silva, Kayla P Pereira, Joana M Pisco, Department of Radiotherapy, ULS Santa Maria, Lisbon 1649-028, Portugal
Tiago Correia de Sá, Hepatobiliopancreatic Surgery and Transplantation Service, Unidade Local de Saude Santo Antonio, Porto 4150, Portugal
Co-first authors: Manuel Carmo Silva and Tiago Correia de Sá.
Author contributions: Carmo Silva M, Correia de Sá T, Pereira KP, and Pisco JM contributed to this paper; Carmo Silva M designed the overall concept, outline, and design of the manuscript and performed the literature review; Carmo Silva M, Correia de Sá T, Pereira KP, and Pisco JM contributed to the discussion, as well as the writing and editing of the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manuel Carmo Silva, MD, Doctor, Department of Radiotherapy, ULS Santa Maria, Av. Prof. Egas Moniz MB, Lisbon 1649-028, Portugal. mj.oliveiracampos@gmail.com
Received: September 8, 2024 Revised: March 16, 2025 Accepted: March 26, 2025 Published online: August 27, 2025 Processing time: 350 Days and 15.3 Hours
Abstract
We provide an editorial of recent findings on early recurrence (ER) in rectal cancer (RC), focusing on the study on ER of resectable RC by Tsai et al. The study established an 8-month recurrence-free survival cut-off for differentiating ER from late recurrence, with implications for postrecurrence survival and overall survival. This offers not only a valuable timeframe for enhancing surveillance strategies in patients at higher risk, especially those who have undergone neoadjuvant chemoradiotherapy (CRT), but also raises questions about its applicability across different populations. Furthermore, the article suggests that while CRT is very effective in reducing locoregional recurrence, this treatment alone may not fully address the overall risk of ER. The authors advocate for personalized risk assessment and intensive surveillance during the postoperative period to improve outcomes, particularly in the first year. Future research should focus on larger, multicenter studies and incorporate advanced diagnostic techniques with genetic and molecular biomarkers to enhance prediction and management of ER. The ultimate goal is to refine treatment and surveillance strategies to improve survival and quality of life for patients with RC.
Core Tip: The identification of an 8-month cut-off to distinguish early recurrence (ER) from late recurrence in rectal cancer emphasizes the importance of targeted surveillance in this period. Factors such as advanced age, preoperative chemoradiotherapy, and longer hospital stays highlight patient subsets that require intensive follow-up. Enhanced surveillance protocols with advanced imaging and molecular biomarkers could better manage recurrence and define risk groups for ER, improving treatment strategies and thus survival outcomes and patients’ quality of life.
