Preoperative irradiation and surgery for local recurrence of rectal and rectosigmoid cancer. Prognostic factors with regard to survival and further local recurrence

Abstract

Preoperative irradiation and surgery can result in an R0-resection and a long survival in patients with recurrence after initial treatment for rectal or rectosigmoid cancer. Also patients with an R1-resection can benefit from surgery since a substantial number will die without further local recurrence. An R0-resection is the main prognostic factor followed by CEA level, sex and type of primary operation. Normalization of CEA after preoperative treatment is not of prognostic significance. The value of the Norwegian follow-up regimen is questioned.

Prevalence of Local Recurrence of Colorectal Cancer at the Iranian Cancer Institute

“…Recurrence in rectal carcinoma is scarcely tolerable for patients because there is a higher risk of permanent stoma that may lead to pelvic exenteration and increased morbidity in patients because of deep pelvic abscess, delay in perineum healing and leakage (Wiig et al, 2007;Ferenschild et al, 2009). Andreoni et al (2007) showed that recurrence in rectal cancer is significantly higher than with colon cancer (14% versus 6.1%; p<000.1).…”

“…It has been shown that the prognosis and survival rate of colon cancer are different from rectal cancer (Wiig et al, 2007;Center et al, 2009;Wang et al, 2010). A thorough knowledge of colorectal cancer would be helpful in establishing better screening and management programs that would improve the quality of life of patients.…”

Surgery for recurrent rectal cancer: technical notes and management of complications

“…The goals of surgery are to achieve an R0 resection, and thus the resection of involved organs needs to be en bloc. However, significant doubt may exist about the exact resection margins; especially, in the presence of radiotherapy-induced fibrosis, and in these situations frozen section analysis of suspect areas can be performed with modification of the procedure as appropriate [14,19,20].…”

Intentionally curative treatment of locally recurrent rectal cancer: a systematic review

“…[3][4][5][6][7][8][9]11,18,19,28,29,30,[33][34][35][36][37]41,44,46,47,[50][51][52][53]56,57 Without prior EBRT, the total dose was 40-60 Gy in most studies, with an overall range of 15-80 Gy. Conventional fractionation (1.8-2.0 Gy per fraction) was uniformly applied in 13 studies, 3,6,7,9,11,18,19,28,30,36,46,50,52 and selective use of a hypofractionated schedule (fractions of 5 Gy) was described in 2 studies. 34 described the use of re-EBRT, 7 of which specified the rate.…”