[Sacral recurrence of rectal carcinoma]

The records and operation reports of 101 patients (52 male, 49 female) with locally recurrent rectal cancer treated between 1980 and 1994 were reviewed. 72% of these patients were symptomatic at the time of diagnosis. 51 patients were operated on with curative intent (16 with IORT), whereas 26 underwent palliative surgical resection. Multivisceral resection was performed in 62.3%. In 24 patients with recurrent tumors (11 with exploratory celiotomy) no major surgical resection was considered indicated. The operative mortality rate was 1.1%. 48 complications occurred in 32 patients with exploratory celiotomy resulting in a 36.3% morbidity rate. In the curative group partial or complete pain relief was achieved in 81%, whereas 75% of those in the palliative group had pain control. The median survival was 24 months for the curative group and 17 months for the group with microscopic or gros residual disease (p < 0.05). Initial inoperability resulted in a median life expectancy of 7 months. The 5-year survival was 13.5% for the group with surgical resection and 21% for patients with curative resection (n = 51). Actuarial 5-year survival for patients who received IORT (n = 16) was 27%, compared with 17% for those (n = 35) who did not (p > 0.05) and respective local tumor control were 50% and 34% (p > 0.05). We conclude that radical resection of tumor recurrence in the pelvis can be performed with acceptable mortality and morbidity, palliates local complaints and offers excellent local control and survival in patients who can undergo complete resections with negative margins.