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Extended Radical Resection: The Choice for Locally Recurrent Rectal Cancer

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

Surgery for recurrent rectal cancer is the only therapy with curative potential. This study was designed to assess factors that affect survival after surgery for locally recurrent rectal cancer.

Methods

Prospective databases of patients undergoing surgical resection for recurrent rectal cancer at three tertiary centers between 1990 and 2006 were combined and analyzed. Cox regression and Kaplan-Meier survival analysis were used to assess factors associated with survival.

Results

A total of 160 patients (96 males) underwent surgery (median age, 63 (range, 27–93) years). Ninety-five patients (59 percent) received neoadjuvant radiotherapy. Sixty-three patients (39 percent) underwent radical resection and 90 (56 percent) underwent extended radical resection. Seven patients (5 percent) were irresectable. There was one death and 27 percent had major postoperative complications, independent of extent of resection. Negative resection margins were obtained in 98 patients (R0 61 percent). Median cancer-specific and overall survival was 48 months (41.5 percent 5-year survival) and 43 months (36.6 percent 5-year survival), respectively. Margin involvement was a significant predictor of cancer-specific (P < 0.001) and overall survival (P < 0.02).

Conclusions

Resection for recurrent rectal cancer results in good survival with acceptable morbidity, unaffected by the extent of resection. Extended radical resection to obtain clear resection margins is the appropriate management of locally recurrent rectal cancer.

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Author information

Authors and Affiliations

  1. Departments of Surgical Oncology and Colorectal Surgery, Peter MacCallum Cancer Centre and St. Vincent’s Hospital, Melbourne, Victoria, Australia

    Alexander G. Heriot M.D., F.R.C.S., F.R.A.C.S & John Mackay F.R.A.C.S

  2. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia

    Christopher M. Byrne M.S., F.R.A.C.S & Michael J. Solomon M.Sc., F.R.A.C.S

  3. Department of Surgery, Christchurch Hospital, Christchurch, New Zealand

    Peter Lee F.R.A.C.S, Bruce Dobbs M.D. & Frank Frizelle M.M.Sci., F.R.A.C.S

  4. St. Richard’s Hospital, Chichester, United Kingdom

    Henry Tilney M.R.C.S

Authors
  1. Alexander G. Heriot M.D., F.R.C.S., F.R.A.C.S
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  2. Christopher M. Byrne M.S., F.R.A.C.S
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  3. Peter Lee F.R.A.C.S
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  4. Bruce Dobbs M.D.
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  5. Henry Tilney M.R.C.S
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  6. Michael J. Solomon M.Sc., F.R.A.C.S
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  7. John Mackay F.R.A.C.S
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  8. Frank Frizelle M.M.Sci., F.R.A.C.S
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Corresponding author

Correspondence to Alexander G. Heriot M.D., F.R.C.S., F.R.A.C.S.

Additional information

Read at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, June 2 to 6, 2007.

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Heriot, A.G., Byrne, C.M., Lee, P. et al. Extended Radical Resection: The Choice for Locally Recurrent Rectal Cancer. Dis Colon Rectum 51, 284–291 (2008). https://doi.org/10.1007/s10350-007-9152-9

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  • DOI: https://doi.org/10.1007/s10350-007-9152-9

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