Surgical resection of locally recurrent colorectal adenocarcinoma

Recurrence rates after curative resection of colorectal adenocarcinoma remain steady at 50 per cent. Thirty per cent of the deaths are linked to locoregional recurrence. The aim of this study was to evaluate the results of resection for locoregional recurrence.

This retrospective review analyzed a series of 120 patients who underwent resection of colonic (56) or rectal (64) locoregional recurrence. Sixty-nine resections were considered as curative. Sixty-one recurrences required extended resection. There were nine synchronous hepatic resections.

The hospital mortality rate was 7 per cent and the morbidity rate was 40 per cent. The overall 5-year survival rate was 27 per cent. Survival was significantly higher: (1) after curative resection (44 versus 0 per cent after palliative resection, P < 0.0001); (2) in women (44 versus 11 per cent for men, P = 0.0036); and (3) after resection for intramural recurrence (45 versus 19 per cent for extramural recurrence, P = 0.0024). Multifactorial analysis showed that curability of the resection was the most important prognostic parameter.

The results in this highly selected group seem to justify an attempt at reresection whenever possible. Long-term results may be improved by using adjuvant treatment.