Abstract
Background: Local recurrence after resection of rectal carcinoma is a difficult clinical problem that adversely affects both survival and quality of life. Surgical resection is possible for a subset of patients with localized recurrences. We reviewed our experience with surgical salvage of recurrent rectal carcinoma, to determine predictors of resectability and postsalvage survival rates.
Methods: A 10-year, retrospective analysis of 131 patients who underwent exploration with curative intent for local recurrence after radical resection of rectal carcinomas, in a single referral institution, was performed. Preoperative and pathological factors were examined for their ability to predict postresection survival rates and resectability.
Results: The overall 5-year survival rate for patients who underwent exploration with curative intent was 24%. Resection of recurrent disease was possible for 103 of 131 (79%) patients, with a resulting 5-year survival rate of 31%. Patients who were treated initially with abdomino-perineal resection (n = 35) presented later and were less likely to have resectable tumors than were those treated initially with some form of sphincter-preserving resection (n = 96). Among patients who could undergo resection, normal carcinoembryonic antigen levels and recurrent disease limited to the bowel wall were both favorable features.
Conclusions: Surgical salvage of local recurrence after radical resection of rectal carcinoma can be performed safely and can result in substantial long-term survival benefits for selected patients.
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Salo, J.C., Paty, P.B., Guillem, J. et al. Surgical Salvage of Recurrent Rectal Carcinoma After Curative Resection: a 10-Year Experience. Ann Surg Oncol 6, 171–177 (1999). https://doi.org/10.1007/s10434-999-0171-8
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DOI: https://doi.org/10.1007/s10434-999-0171-8