Local recurrence of rectal cancer occurs in up to 30% after radical surgica
l treatment and it represents a formidable challenge to surgeons and oncolo
gist, presenting most of times within two years after proper therapy have b
een provided. Although chemoradiation therapy reduces the rate of it, it ha
s no any impact in survival. On the other hand, it has been proved that alm
ost 50% of recurrences are without evidence of systemic disease and amenabl
e to surgical resection, by the time of diagnose. For this reason there are
a number of authors currently arguing a more agressive treatment for this
entity in order to improve survival and reduces recurrence rate.
Radical pelvic surgery for recurrent rectal cancer should be performed prim
arily with curative intent in patients without evidence:of extrapelvic or d
istant spread. Abdominosacral resection represents a therapeutic option for
patients with specific type of pelvic recurrence providing, according to f
igures from the most experienced groups, an actuarial survival rates of alm
ost 33% at four years in a group of patients with a life expectancy, by oth
er means, round seven months.
We present our experience with this surgical procedure in Surgical Oncology
Department at Roger Williams Cancer Center in Providence, leads by HJ. Wan
ebo.