LOCAL RECURRENCE OF RECTAL ADENOCARCINOMA AFTER CURATIVE SURGERY WITHAND WITHOUT PREOPERATIVE RADIOTHERAPY

The natural history of locally recurrent rectal cancer was analysed to assess whether preoperative irradiation altered the clinical course o f the disease. In a randomized controlled trial of 849 patients, the v alue of preoperative radiotherapy in those with operable rectal adenoc arcinoma was examined. After a minimum follow-up of 4 years, 156 patie nts who developed local recurrence were studied retrospectively. There were no differences concerning symptoms and the site of local recurre nce between irradiated and non-irradiated patients. Curative treatment was rarely possible and median survival was only about 1 year, irresp ective of adjuvant treatment. Local recurrence was the only manifestat ion of disease in 30-50 per cent of patients. An earlier and more aggr essive surgical approach might improve survival.