Revista Brasileira de Coloproctologia
Print version ISSN 0101-9880
LEAL, Raquel Franco et al. Local recurrence of rectal cancer: surgical approach. Rev bras. colo-proctol. [online]. 2008, vol.28, n.1, pp. 40-45. ISSN 0101-9880. http://dx.doi.org/10.1590/S0101-98802008000100006.
Local recurrence after rectal cancer resection varies between 3 to 35% in five years. The condition has difficult management, and little is known about the best treatment. Radiotherapy and chemotherapy can be used as paliative methods, and the best results are achieved with radical resection. PURPOSE: To evaluate patients submitted to surgery for pelvic recurrence by the Coloproctology Unit at Clinical Hospital of Unicamp. METHODS AND PATIENTS: Between 1999 and 2007, 26 consecutive patients with locally recurrence after rectal cancer surgery were evaluated. According to clinical data, tumor stage at the first surgery, recurrence ressecability and follow-up were analyzed. RESULTS: The most common initial surgery was retossigmoidectomy with colorectal anastomosis (46,1%). Of the 26 patients, five had tumor perforation at the first surgery. Positive lynphnodes were found in 53,8% and 69,2% were classified as T3 or T4 staging. In relation to surgery for local recurrence, the principle was abdominoperineal amputation of the rectum. Radical surgery was performed in 42,3% of the cases. The resection of the tumor was possible in 65,4%. The mean follow-up period was 29,4 months, with an overall survival of 34,6%. CONCLUSION: Approximately two-thirds of patients with locally recurrent rectal cancer can be submitted for surgical resection, improving survival. This surgical intervention should be encouraged in hospitals with multidisciplinary teams to improve quality of life in selected patients.
Keywords : Adenocarcinoma of the rectum; local recurrence; surgery.