Abstract
In the late twenty-first century, there has been a significant decrease in local recurrence after curative surgery for primary rectal cancer, with both the introduction of TME (total mesorectal excision) and neoadjuvant radiotherapy. The keys to successful treatment of both local and distal rectal cancer recurrence are early detection, specific diagnosis of location and resectability (whether R0 can be achieved), and aggressive complete clearance. The treatment of anastomotic recurrence has more favourable outcomes than does management of pelvic recurrence, while pulmonary and liver metastases being the most common distal recurrence location. The diagnosis and treatment must be led by experienced multidisciplinary teams (MDT) following a coherent algorithm. The MDT must have access to multiple treatment options including radiotherapy, chemotherapy, carbon-ion radiation advanced surgical techniques, multidisciplinary surgical teams, and appropriate facilities.
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Asoglu O, Karanlik H, Muslumanoglu M, et al. Prognostic and predictive factors after surgical treatment for locally recurrent rectal cancer: a single institute experience. Eur J Surg Oncol. 2007;33:1199.
Bhangu A, Brown G, Akmal M, Tekkis P. Outcome of abdominosacral resection for locally advanced primary and recurrent rectal cancer. Br J Surg. 2012;99:1453.
Bikhchandani J, Ong GK, Dozois EJ, Mathis KL. Outcomes of salvage surgery for cure in patients with locally recurrent disease after local excision of rectal cancer. Dis Colon Rectum. 2015;58:283.
Bouchard P, Efron J. Management of recurrent rectal cancer. Ann Surg Oncol. 2010;17:1343.
Boyle KM, Sagar PM, Chalmers AG, et al. Surgery for locally recurrent rectal cancer. Dis Colon Rectum. 2005;48:929.
Camilleri-Brennan J, Steele RJ. The impact of recurrent rectal cancer on quality of life. Eur J Surg Oncol. 2001;27:349.
Colibaseanu DT, Dozois EJ, Mathis KL, et al. Extended sacropelvic resection for locally recurrent rectal cancer: can it be done safely and with good oncologic outcomes? Dis Colon Rectum. 2014;57:47.
Colibaseanu DT, Mathis KL, Abdelsattar ZM, et al. Is curative resection and long-term survival possible for locally re-recurrent colorectal cancer in the pelvis? Dis Colon Rectum. 2013;56:14.
Faneyte IF, Dresen RC, Edelbroek MA, et al. Pre-operative staging with positron emission tomography in patients with pelvic recurrence of rectal cancer. Dig Surg. 2008;25:202.
Guren MG, Undseth C, Rekstad BL, et al. Reirradiation of locally recurrent rectal cancer: a systematic review. Radiother Oncol. 2014;113:151.
Hahnloser D, Nelson H, Gunderson LL, et al. Curative potential of multimodality therapy for locally recurrent rectal cancer. Ann Surg. 2003;237:502.
Harris CA, Solomon MJ, Heriot AG, et al. The outcomes and patterns of treatment failure after surgery for locally recurrent rectal cancer. Ann Surg. 2016;264:323.
Henry LR, Sigurdson E, Ross EA, et al. Resection of isolated pelvic recurrences after colorectal surgery: long-term results and predictors of improved clinical outcome. Ann Surg Oncol. 2007;14:1081.
Heriot AG, Byrne CM, Lee P, et al. Extended radical resection: the choice for locally recurrent rectal cancer. Dis Colon Rectum. 2008;51:284.
Kapiteijn E, Marijnen CA, Nagtegaal ID, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med. 2001;345:638.
Kim YW, Kim NK, Min BS, et al. Factors associated with anastomotic recurrence after total mesorectal excision in rectal cancer patients. J Surg Oncol. 2009;99:58.
Kusters M, Marijnen CA, van de Velde CJ, et al. Patterns of local recurrence in rectal cancer; a study of the Dutch TME trial. Eur J Surg Oncol. 2010;36:470.
Messiou C, Chalmers AG, Boyle K, et al. Pre-operative MR assessment of recurrent rectal cancer. Br J Radiol. 2008;81:468.
Mirnezami AH, Sagar PM, Kavanagh D, et al. Clinical algorithms for the surgical management of locally recurrent rectal cancer. Dis Colon Rectum. 2010;53:1248.
Palmer G, Martling A, Cedermark B, Holm T. A population-based study on the management and outcome in patients with locally recurrent rectal cancer. Ann Surg Oncol. 2007;14:447.
Park JK, Kim YW, Hur H, et al. Prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer: impact of patterns of pelvic recurrence on curative resection. Langenbecks Arch Surg. 2009;394:71.
Sebag-Montefiore D, Stephens RJ, Steele R, et al. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet. 2009;373:811.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7.
Susko M, Lee J, Salama J, et al. The use of re-irradiation in locally recurrent, non-metastatic rectal cancer. Ann Surg Oncol. 2016;23:3609.
Suzuki K, Dozois RR, Devine RM, et al. Curative reoperations for locally recurrent rectal cancer. Dis Colon Rectum. 1996;39:730.
Tanis PJ, Doeksen A, van Lanschot JJ. Intentionally curative treatment of locally recurrent rectal cancer: a systematic review. Can J Surg. 2013;56:135.
The Beyond TME Collaborative. Consensus statement on the multidisciplinary management of patients with recurrent and primary rectal cancer beyond total mesorectal excision planes. Br J Surg. 2013;100:1009–14.
van den Brink M, Stiggelbout AM, van den Hout WB, et al. Clinical nature and prognosis of locally recurrent rectal cancer after total mesorectal excision with or without preoperative radiotherapy. J Clin Oncol. 2004;22:3958.
Yamada S, Kamada T, Ebner D, et al. Carbon-ion radiation therapy for pelvic recurrence of rectal cancer. Int J Radiat Oncol Biol Phys. 2016;96(1):93–101.
You YT, Chen JS, Wang JY, et al. Concurrent chemoradiotherapy in the treatment of locally recurrent rectal cancer. Hepatogastroenterology. 2013;60:94.
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White, I., Avital, S. (2020). Recurrent Rectal Cancer. In: Steele, S., Maykel, J., Wexner, S. (eds) Clinical Decision Making in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65942-8_43
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DOI: https://doi.org/10.1007/978-3-319-65942-8_43
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