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Reoperation for intraluminal rectal cancer recurrence
Lucas R Rudmik1, W Donald Buie, John A Heine
1Department of Surgery, University of Calgary, Alberta, Canada.
Diseases of the Colon and Rectum
|July 2, 2005
Summary
Intraluminal recurrence after rectal cancer surgery is rare but treatable. Re-operation can lead to successful locoregional control and disease-free survival in these patients.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Locoregional recurrence after rectal cancer resection occurs in approximately 5% of cases, often intraluminally due to tumor exfoliation.
- The outcomes of isolated intraluminal recurrence, including resectability, locoregional control, and survival, are not well-documented.
Purpose of the Study:
- To evaluate the resectability, locoregional control, and survival rates in patients experiencing isolated intraluminal recurrence following rectal cancer resection.
Main Methods:
- A cohort of nine patients with isolated intraluminal rectal cancer recurrence treated between 1994 and 2003 was retrospectively analyzed.
- All patients underwent curative re-resection, and outcomes were assessed through follow-up evaluations.
Main Results:
- All nine patients achieved pathologically clear margins after re-resection.
- No patient developed further locoregional recurrence post-re-operation.
- Six of nine patients remain alive and disease-free with a median follow-up of 34.5 months; one died disease-free, and two developed distant metastases.
Conclusions:
- Endoscopic surveillance is recommended after sphincter-sparing rectal cancer resection to detect intraluminal recurrence.
- Re-resection for intraluminal recurrence offers a viable strategy for achieving locoregional control and significant disease-free survival.