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Second-look surgery for recurrent colorectal carcinoma: is it worthwhile?
1Laboratory for Cancer Biology, New England Deaconess Hospital, Boston, Massachusetts 02215.
Seminars in Surgical Oncology
|May 1, 1991
Summary
Second-look surgery for recurrent colorectal cancer is only worthwhile if the goal is complete disease removal. Palliative surgeries likely do not improve survival without effective systemic therapies.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- Second-look surgery for colorectal cancer recurrence has been debated for over 40 years.
- Follow-up strategies evolved from routine to clinically or CEA-directed approaches since the mid-1970s.
Purpose of the Study:
- To review the efficacy of second-look surgery for recurrent colorectal carcinoma.
- To determine if second-look surgery is a worthwhile intervention for patients.
Main Methods:
- Review of existing literature and surgical outcomes for second-look procedures in recurrent colorectal cancer.
- Analysis focused on non-symptomatic patient cohorts.
Main Results:
- Second-look surgery for recurrent colorectal cancer should aim for complete disease eradication.
- Palliative or debulking procedures without effective systemic therapy are unlikely to enhance survival.
Conclusions:
- The primary indication for second-look surgery in recurrent colorectal cancer is curative intent.
- Isolated liver, pulmonary, or regional recurrences are the most suitable candidates for a potentially curative second-look approach.