Therapy results of locoregional recurrences in rectal cancer

Despite of advanced surgical technique and multimodality therapy results following secondary resection of local recurrence after rectal cancer are discussed controversially. Patients and methods: Between 1990 and 1999 81 patients with local recurrence of rectal cancer were treated at our surgical department. Median age was 63 years, 62% of patients were male. 98% of recurrences were in local advanced stage (74% = rT4, 25% = rT3), 44% of patients had synchronous distant metastases. Results: 32 patients underwent resection of recurrent rectal cancer. Potential curative surgery was possible in 56% of resections. Extended resections of adjacent organs were necessary in 21 patients. The 4-year survival in the curative group was 44% compared to 19% in patients with microscopic or gross residual disease. Conclusion: Optimistic long-term results in recurrent rectal cancer can only be achieved after curative resection. Preoperative radiochemotherapy in advanced cancers increases curative resection and probably survival rate.