[Treatment of local recurrence of rectal cancer]

Local recurrence (LR) still occurs in 5-10% of patients after surgery for a primary rectal cancer and is a major clinical problem, due to severe symptoms and poor survival. Patients with LR must be staged with regard to local tumour extension and distant disease. Magnetic resonance imaging and positron emission tomography-computed tomography are currently used for these purposes. A complete resection often implies a pelvic exenteration. The postoperative complication rate is high and therefore the patients must be carefully selected and counseled before surgery. If a R0 resection the prognosis is good with a 5-year survival about 55%.