title: Local recurrence of rectal adenocarcinoma after 'curative' surgery with and without preoperative radiotherapy.
abstract: The natural history of locally recurrent rectal cancer was analysed to assess whether preoperative irradiation altered the clinical course of the disease. In a randomized controlled trial of 849 patients, the value of preoperative radiotherapy in those with operable rectal adenocarcinoma was examined. After a minimum follow-up of 4 years, 156 patients who developed local recurrence were studied retrospectively. There were no differences concerning symptoms and the site of local recurrence between irradiated and non-irradiated patients. Curative treatment was rarely possible and median survival was only about 1 year, irrespective of adjuvant treatment. Local recurrence was the only manifestation of disease in 30-50 per cent of patients. An earlier and more aggressive surgical approach might improve survival.
authors.affiliation: Department of Surgery, Karolinska Hospital, Stockholm, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Holm
authors.forename: B
authors.initials: B
authors.lastname: Cedermark
authors.forename: L E
authors.initials: LE
authors.lastname: Rutqvist
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors