Potentially curative resection for locoregional recurrence of colorectal cancer.

PURPOSE

Local recurrence after curative surgery for colorectal cancer may be treated by potentially curative surgery, defined as resection of all macroscopic disease. We conducted this retrospective study to show the effectiveness of potentially curative resection for patients with locoregional recurrence (LRR).

METHODS

We reviewed the records of 242 patients who underwent curative resection of colorectal cancer in our unit between 1988 and 2000. Locoregional recurrence developed in 50 (20.6%) patients, and was treated by R0 resection in 10 (20%) patients (group R0), by R1 resection in 8 (16%) patients (group R1), by R2 resection in 13 (26%) patients (group R2), and by surgery without resection in 12 (24%) patients (group NR). Seven (15%) patients did not undergo surgery (group NS).

RESULTS

The mean survival periods were 48, 36, 10, 5.6, and 5 months in groups R0, R1, R2, NR, and NS, respectively. There was no significant difference in survival between groups R0 and R1 (P = 0.5), but survival was significantly longer in groups R0 and R1 than in groups R2, NR, and NS (P = 0.001).

CONCLUSION

These findings show that surgeons should aim to achieve at least macroscopic clearance of the recurrent tumor. Potentially curative surgery improves survival in selected patients with LRR after curative resection of colorectal cancer.