This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Outcome of surgical resection of second‐time locally recurrent rectal cancer. BJS 2013; 100: 403-409.
Published: 7th December 2012
Authors: D. P. Harji, P. M. Sagar, K. Boyle, S. Maslekar, B. Griffiths, D. R. McArthur et al.
Background
Locally recurrent rectal cancer relapses in the pelvis in up to 60 per cent of patients following resection. This study assessed the surgical and oncological outcomes of patients who underwent surgery for re‐recurrent rectal cancer.
Method
Patients who underwent second‐time resection of locally recurrent rectal cancer between 2001 and 2010 were eligible for inclusion. Data were collected on demographics, presentation of disease, preoperative staging imaging, adjuvant therapy, operative detail, histopathology and follow‐up status (clinical and imaging) for the primary tumour, and first and second recurrences.
Results
Thirty patients (of 56 discussed at the multidisciplinary meeting) underwent resection of re‐recurrent rectal cancer. Postoperative morbidity occurred in nine patients but none died within 30 days. Negative resection margins (R0) were achieved in ten patients, microscopic margin positivity (R1) was evident in 15 and macroscopic involvement (R2) was found in five. Although no patient had distant metastatic disease, 22 had involvement of the pelvic side wall. One‐ and 3‐year overall survival rates were 77 and 27 per cent respectively, with a median overall survival of 23 (range 3–78) months. An R0 resection conferred a survival benefit (median survival 32 (11–78) months versus 19 (6–33) months after R1 and 7 (3–10) months after R2 resection).
Conclusion
Surgical resection of re‐recurrent rectal cancer had comparable surgical and oncological outcomes to initial recurrences in well selected patients. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Full text