[Current surgical strategy of locally recurrent rectal cancer]

The incidence of locally recurrent rectal cancer (LRRC) is less than 10% following treatment for primary rectal cancer, while LRRC usually has serious symptoms and a very low survival rate when lack of treatment. For further efficacy improvement of LRRC operation, recent research topics include preoperative precise evaluation, correct decision, reasonable individual treatment by multidisciplinary collaboration. Surgery remains the only option for potential cure. Studies show R0 resection is the most important prognostic factor. Peking University First Hospital proposes a new classification of LRRC: Pelvic cavity is divided into right pelvic wall, left pelvic wall and posterior sacrococcyx. LRRC is classified as F0 to F3 according to invasion quantity in pelvic wall or sacrococcyx. This classification is more suitable for clinical practice. Though determining the LRRC location by CT, MRI and PET, scientific classification evaluation and correct choice of proper patients using F classification to fix the extent of pelvic wall can effectively elevate the R0 resection rate, and at the same time, can avoid ineffectual high-risk re-operation. This article also investigates the efficacy of comprehensive treatment based on preoperative neoadjuvant therapy, intra-operative radiotherapy and re-radiotherapy, in order to provide the guidance for the institution of reasonable and scientific treatment strategy in clinic.