[A resected case of pathologically complete response of a pelvic recurrence from rectal cancer after chemoradiotherapy with S-1].

The patient was a 58-year-old man who had been performed a low anterior resection for an advanced upper rectal cancer (T3N0M0, Stage II). At fourteen months after primary operation, follow-up CT scan, MRI and FDG-PET showed a pelvic recurrence located at upper presacral region. Following radiotherapy combined with S-1, we performed a curative surgical resection. Pathologically, an extensive fibrosis was shown without a tumor cell. Complete surgical removal of the recurrent disease remains the best chance of cure after a local recurrence. But in the case of recurrent tumor located in upper presacral region and extended to the pelvic side-wall, it is very difficult to achieve negative resection margins. So selection of patients is very important to reduce the risk of positive surgical margins. We experienced a resected case of pathologically complete response of a pelvic recurrence from rectal cancer after chemoradiotherapy with S-1. This case suggests the neoadjuvant chemoradiotherapy has potential to improve management of locally recurrent rectal cancer.