[Treatment for intrapelvic recurrence of rectal cancer--resection versus chemotherapy]

This retrospective study was performed to clarify problems associated with surgery for local recurrence of rectal cancer in recent years when new anticancer drugs have come out to be available. We compared the background characteristics and treatment outcomes of patients who underwent resective surgery (resection group, n=9) and those who received chemotherapy comprised of new aniticancer drugs (chemotherapy group, n=5) for intrapelvic recurrence of rectal cancer between 1997 and 2008. In the resection group, the types of surgery included were abdomino-perineal resection in 1, posterior exenteration in 4, total pelvic exenteration in 4 and 5 who underwent sacrectomy. In the chemotherapy group, chemotherapy was continued to second-line treatment in 4 patients and third-line in 1. Oxaliplatin was given to 3 patients, irinotecan to 3, and Leucovorin to 5. The two groups did not significantly differ regarding various background factors including age, sex, stage at resection of the primary lesion, and the interval between resection of the primary lesion and detection of recurrence. The overall survival period after the start of treatment for recurrence did not significantly differ between the two groups (p=0.73). Patient's selection seems to have become a more important factor for resective surgery for intrapelvic recurrence of rectal cancer in recent years when the efficacy of new anticancer drugs is expected.