[Diagnostic and therapeutic strategies in locally recurrent rectal cancer]

Following curative operation for rectal cancer, 14-44% of the patients develop a local recurrence, in most instances situated in the operative bed. Differentiation of recurrent tumor, scar tissue and inflammation is not always possible by computerized tomography and magnetic resonance imaging. Recurrent tumor in these patients is diagnosed by percutaneous biopsy and histological analysis. In 24 patients in whom operation was impossible and a maximum irradiation dose was also applied, chemotherapy was administered in the form of regional perfusions. The internal iliac arteries were perfused with folinic acid and 5-fluorouracil in these patients. This procedure reduced the intensity of pain or achieved a pain-free interval of 9 days to 8 months.