Curative reoperations for locally recurrent rectal cancer

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• Locally recurrent rectal cancer presents a significant clinical challenge.
• Reoperation for cure is a complex decision with potential for morbidity and impact on survival.

Purpose of the Study:

• To assess morbidity, survival, influencing factors, and failure patterns in patients undergoing reoperation for cure of locally recurrent rectal cancer.
• To identify predictors of successful outcomes after surgical intervention for recurrent rectal cancer.

Main Methods:

• A retrospective review of 224 patients who underwent surgery for recurrent rectal cancer between 1981 and 1988.
• Focus on 65 patients who underwent further surgery with curative intent (no residual disease).
• Analysis of factors including original operation type, time to recurrence, symptom status, tumor fixation, reoperation type, and adjuvant therapy.

Main Results:

• No in-hospital deaths within 30 days of reoperation; 14 patients experienced 17 complications.
• Curative resection resulted in significantly better survival than palliative resection (P < 0.001).
• Three-year and five-year survival rates were 57% and 34%, respectively; median survival was 44.7 months. Local failure rates at 1, 3, and 5 years were 24%, 41%, and 47%.

Conclusions:

• Complete excision of locally recurrent rectal cancer is feasible and can achieve long-term survival in carefully selected patients.
• Reoperation for recurrent rectal cancer can be performed safely, offering a chance for cure.
• Factors such as curative intent and absence of pain may influence survival outcomes.