SURVIVAL AFTER SURGICAL-TREATMENT OF RECURRENT CARCINOMA OF THE RECTUM

BACKGROUND: From January 1983 to January 1991, radical surgical treatm ent for carcinoma of the rectum was performed upon 154 patients in our department. In 30 instances, local treatment failure occurred and pat ients were treated either conservatively or operatively. Survival time s of these 30 patients were compared to evaluate if operation, even in instances in which only palliative reresection is possible, can prolo ng survival and if early diagnosis of recurrence leads to a higher rat e of radical resections and subsequent cure. STUDY DESIGN: Patients we re divided into three groups. Group 1 consisted of patients not underg oing an operation, patients in group 2 had a palliative resection and patients in group 3 had radical resections. The median survival time w as estimated for each group. RESULTS: The median survival period was s ix months for group 1, 17 months for group 2, and 35.5 months for grou p 3. Four patients who underwent reoperation for cure are still alive: one with recurrent tumor after 28 months, and three without evidence of disease after 32, 42 and 43 months. The most valuable diagnostic me an in the detection of local recurrence was endosonography. CONCLUSION S: Surgical treatment far recurrent carcinoma of the rectum is justifi ed not only in cases having radical resection but also as a palliative approach. Compared to other investigative methods, endosonography see ms to detect recurrences earlier, at a time when curative retreatment is still possible.