[Is surgical therapy of locoregional recurrence of resected colorectal cancer effective?].
The role of surgery in the treatment of local recurrence of colorectal carcinoma is controversial. This study aims to analyse the value of surgical reintervention. From July 1982 to June 1991 157 patients were treated for local recurrence after "curative resection" of primary colorectal carcinoma in our institution. The mean age was 60.3 years. In 67 patients tumor recurred in the pelvis (45% distant metastases) and in 90 patients in the abdomen (39% distant metastases). Intraluminal recurrence was found in 55 patients (35%), extraluminal recurrence in 102 patients (65%). The mean interval between primary tumor resection and recurrence was 24 months. The resection rate was 73.9% (n = 116). R0-resection was achieved in 38% (n = 44). There was no significant difference in the R0-resection rate between pelvic and abdominal recurrences (33% vs. 41%). In contrast to that intraluminal tumors showed a significant difference in R0-resections when compared with extraluminal tumor recurrences (57% vs. 23%). In 34 patients (22%) only palliative surgery was performed, while in 7 patients (45%) no surgical intervention was possible at all. Multivisceral resections were necessary in 36% of pelvic and in 81% of abdominal recurrences. The postoperative complication rate was 58% (19% major complications), mortality was 3.4%. For R0-resection mean survival was 44.1 months, for R1-resection 16.5 months and for R2-resection 10.9 months. Survival in intraluminal recurrences was 42 months compared with 13.8 months in extraluminal tumors. Tumor location (abdominal/pelvic) had no influence on survival.(ABSTRACT TRUNCATED AT 250 WORDS)
Huber
F T
FT
Chirurgische Klinik und Poliklinik, Technische Universität München.
Siewert
J R
JR
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D012086:Reoperation; D015996:Survival Rate
Lohnt die chirurgische Therapie des lokoregionalen Rezidivs nach reseziertem kolorektalem Karzinom?