Surgical management for loco-regional recurrence in rectal cancer

Abstract EN

Purpose: The aim of this study was to determine the morbidity, survival and patterns of failure for locally recurrent rectal cancer patients who underwent further surgery with the hope of cure.

Evaluation of the accuracy of radiological imaging in early detection of local recurrence was a second aim.

Methods: Between May 1999 and December 2002, 30 patients with a preoperative diagnosis of recurrent rectal cancer underwent additional surgery at National Cancer Institute, Cairo University.

Patients with isolated locoregional recurrence, fit for surgery and with detailed record of the previous treatment of their initial tumor were included in the study.

Factors assessed included type of original operation, time interval between operation for primary tumor and recurrence, symptom status, types of reoperations for recurrence and adjuvant therapy.

Results: There were 2 postoperative mortalities.

Complications were observed in 17 patients and infection was the most common.

Only 4 patients required surgical intervention.

Twenty-two patients had no gross/microscopic residual disease at tumor margins after reoperation.

Twelve patients developed second tumor recurrence.

Our median disease free survival was 23.5 months.

Conclusion: Complete excision of locally recurrent rectal cancer with curative intent was feasible.

It provided a significant number of patients with long-term survival.

It offered an excellent palliation for the remaining cases.

Extended surgery can be accomplished safely in selected patients.