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.
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.
Authors: Peng Du; John P Burke; Wisam Khoury; Ian C Lavery; Ravi P Kiran; Feza H Remzi; David W Dietz Journal: Int J Colorectal Dis Date: 2016-02-10 Impact factor: 2.571
Authors: Amar U Kishan; Justin C Voog; Jonathan Wiseman; Ryan R Cook; Marek Ancukiewicz; Percy Lee; David P Ryan; Jeffrey W Clark; David L Berger; James C Cusack; Jennifer Y Wo; Theodore S Hong Journal: Br J Radiol Date: 2017-06-14 Impact factor: 3.039
Authors: Dieter Hahnloser; Heidi Nelson; Leonard L Gunderson; Imran Hassan; Michael G Haddock; Michael J O'Connell; Stephen Cha; Daniel J Sargent; Alan Horgan Journal: Ann Surg Date: 2003-04 Impact factor: 12.969
Authors: F Selvaggi; C Fucini; G Pellino; G Sciaudone; I Maretto; I Mondi; N Bartolini; F Caminati; S Pucciarelli Journal: Tech Coloproctol Date: 2014-11-11 Impact factor: 3.781
Authors: Thijs Wieldraaijer; Pascal Bruin; Laura A M Duineveld; Pieter J Tanis; Anke B Smits; Henk C P M van Weert; Jan Wind Journal: Dig Surg Date: 2017-03-14 Impact factor: 2.588