LOCAL AND REGIONAL RECURRENCES AFTER OPERATED RECTAL-CANCER

Citation
M. Adloff et al., LOCAL AND REGIONAL RECURRENCES AFTER OPERATED RECTAL-CANCER, Annales de chirurgie, 47(7), 1993, pp. 616-625
Citations number
NO
Categorie Soggetti
Surgery
Journal title
ISSN journal
00033944
Volume
47
Issue
7
Year of publication
1993
Pages
616 - 625
Database
ISI
SICI code
0003-3944(1993)47:7<616:LARRAO>2.0.ZU;2-R
Abstract
Local tumor recurrence rates after curative rectal cancer surgery are reportedly high and herald a poor diagnosis. Extramural recurrence is most common and is due to the failure to remove all of the tumor durin g the initial operation. In the rarer anastomotic recurrence, the impl antation of exfoliated malignant cells is possible, but histochemical changes in the mucosa surrounding a tumor may be considered as an alte rnative cause of local recurrence. Local recurrence rates did not impr ove when the distal margins were extended over 2 cm, but microscopic l ateral tumor extension appears to be the major determinant of recurren ce. Early diagnosis is based on frequent CEA assays, history, physical examination, endoscopy, endoluminal ultrasound and pelvic CT scan. Ag gressive treatment involving a combination of field irradiation, surgi cal debulking and intra-operative radiation can result in local contro l and long-term survival in 10 to 25 % of patients.