Purpose: The objective of this study was to analyze retrospectively the early perioperative results in a cohort of 53 patients with localy reccurent colorectal cancer (CRC).
Material and methods: The study covered 53 patients with CRC 21 males and 32 females at a mean age of 62 years treated in the Clinic of Liver, Biliary, Pancreatic and General Surgery, Tokuda Hospital of Sofia, during the period from January 2007 to March 2013. Any necessary diagnostic and surgical methods were applied.
Results: The locally recurrent CRC is a challenge for the surgeon because of the fact that in most cases it engages adjacent anatomical structures and organs, on the one hand, and it is accompanied by complications, on the other hand.
Conclusion: Achievement of good late results in patients with recurrent CRC is due to radicality of the interventions. Most often, they should be multivisceral resections. The presence of intestinal obstruction of varying degree and of synchronous peritoneal and liver metastases commonly limit the possibilities for surgical interference with the disease. Particular attention should be paid to possible neoadjuvant treatment capable of reducing the stage of diasease and improving the perioperative outcomes. Therapeutic behaviour should be strictly individual and consider any possible options. The experience of the surgical team is extremely important, too.
Adloff, M., J. P. Arnaud, M. Schloegel, D.
Thibaud. Factors influencing local recurrence
after abdominoperineal resection for cancer of
the rectum.- Dis. Colon Rectum, 28, 1985, No 6,
-415.
Bowne, W. B., B. Lee, W. D. Wong, L. Ben-Porat, J.
Shia, A. M. Cohen, et al. Operative salvage for
locoregional recurrent colon cancer after curative
resection: an analysis of 100 cases.- Dis. Colon
Rectum, 48, 2005, No 5,897-909.
Galandiuk, S., H. S. Wieand, C. G. Moertel, S. S.
Cha, R. J. Fitzgibbons, Jr., J. H. Pemberton, et al.
Patterns of recurrence after curative resection of
carcinoma of the colon and rectum.- Surg. Gynecol.
Obstet., 174, 1992, No 1, 27-32.
Guillem, J., L. Ruo. Strategies in operative therapy
for locally recurrent rectal cancer.- Semin. Colon
Rectal Surg., 9, 1998, 259-268.
Hartley, J. E., R. A. Lopez, P. B. Paty, W. D. Wong,
A. M. Cohen, J. G. Guillem. Resection of locally
recurrent colorectal cancer in the presence of
distant metastases: can it be justified?- Ann. Surg.
Oncol., 10, 2003, No 3, 227-233.
Hellinger, M. D., C. A. Santiago. Reoperation for
recurrent colorectal cancer.- Clin. Colon Rectal
Surg., 19, 2006, No 4, 228-236.
Maetani, S., T. Nishikawa, Y. Iijima, T. Tobe, Y.
Kotoura, J. Shikata. Extensive en bloc resection
of regionally recurrent carcinoma of the rectum.-
Cancer, 69, 1992, No 12, 2876-2883.
Mannaerts, G. H., H. J. Rutten, H. Martijn,
P. E. Hanssens, T. Wiggers. Comparison of
intraoperative radiation therapy-containing
multimodality treatment with historical treatment
modalities for locally recurrent rectal cancer.- Dis.
Colon Rectum, 44, 2001, No 12, 1749-1758.
Moore, H. G., M. Shoup, E. Riedel, B. D. Minsky, K.
M. Alektiar, M. Ercolani,, et al. Colorectal cancer
pelvic recurrences: determinants of resectability.-
Dis. Colon Rectum, 47, 2004, No 10, 1599-1606.
Obrand, D. I., P. H. Gordon. Incidence and patterns
of recurrence following curative resection for
colorectal carcinoma.- Dis. Colon Rectum, 40, 1997,
No 1, 15-24.
Pilipshen, S. J., M. Heilweil, S. H. Quan, S.
S. Sternberg, W. E. Enker. Patterns of pelvic
recurrence following definitive resections of rectal
cancer.- Cancer, 53, 1984, No 6, 1354-1362.
Read, T. E., M. G. Mutch, B. W. Chang, M. S.
McNevin, J. W. Fleshman, E. H. Birnbaum, et al.
Locoregional recurrence and survival after curative
resection of adenocarcinoma of the colon.- J. Am.
Coll. Surg., 195, 2002, No 1, 33-40.
Rich, T. A., N. H. Terry, M. Meistrich, K. Cleary,
D. Ota. Pathologic, anatomic, and biologic factors
correlated with local recurrence of colorectal
cancer.- Semin. Radiat. Oncol., 3, 1993, No 1,13-19.
Rödel, C., G. G. Grabenbauer, K. E. Matzel,
C. Schick, R. Fietkau, T. Papadopoulos, et al.
Extensive surgery after high dose preoperative
chemoradiotherapy for locally advanced recurrent
rectal cancer.- Dis. Colon Rectum, 43, 2000, No 3,
-319.
Sagar, P. M., J. H. Pemberton. Surgical management
of locally recurrent rectal cancer.- Br. J. Surg., 83,
, No 3, 293-304.
Shibata, D., P. B. Paty, J. G. Guillem, W. D.
Wong, A. M. Cohen. Surgical management of
isolated retroperitoneal recurrences of colorectal
carcinoma.- Dis. Colon Rectum, 45, 2002, No 6,
-801.
Shumate, C. R., T. A. Rich, J. M. Skibber, J. A.
Ajani, D. M. Ota. Preoperative chemotherapy and
radiation therapy for locally advanced primary and
recurrent rectal carcinoma.- Cancer, 71, 1993,
No 11, 3690-3696.
Taylor, W. E., J. H. Donohue, L. L. Gunderson,
H. Nelson, D. M. Nagorney, R. M. Devine, et al.
The Mayo Clinic experience with multimodality
treatment of locally advanced or recurrent colon
cancer.- Ann. Surg. Oncol., 9, 2002, No 2, 177-185.
Waldron, R. P., I. A. Donovan. Clinical follow
up and treatment of locally recurrent colorectal
cancer.- Dis. Colon Rectum, 30, 1987, No 6,
-430.
Email this article (Login required) 
