[Two cases of curative resection for locally recurrent rectal cancer with high-level sacrectomy after preoperative chemoradiation therapy (CRT)].
We herein report two cases of locally recurrent rectal cancer that were successfully treated by surgical resection of shrunken tumor by pre-operative CRT. Although one case had a relapse in 7 months after the operation, the prognostic difference between two cases was discussed. CASE 1: A 54-year-old male had a pre-sacral mass (54 mm) six months after an anterior resection for advanced rectal cancer. We planned a surgical resection after CRT (radiation 50 Gy, CPT-11, UFT and LV). The tumor had a good response (33 mm) allowing a dissection area between sacral bone and posterior margin. Low anterior resections with sacral bone resection (below S3) were done to prevent S1 nerve roots injury and spinal fluid leakage. Macroscopically, a surgical margin was well secured. The patient is alive for 84 months after the surgery without an evidence of recurrence. CASE 2: A 66-year-old man had an anal bleeding. He underwent Hartmann's maneuver for advanced rectal cancer. MRI revealed a recurrent tumor (66 mm) occupying up to the 1st sacral bone. CRT was carried out. After a tumor response was (35 mm) obtained, and total pelvic exenteration with sacral bone resection below S3 was carried out, achieving R0 operation. However, He had relapsed at 7 months after the operation.
Dept. of Gastroenterological Surgery, Osaka University, Graduate School of Medicine.
Katsuya
K
Ohta
Masataka
M
Ikeda
Yoshinori
Y
Kagawa
Masahisa
M
Ohtsuka
Ichiro
I
Takemasa
Tsunekazu
T
Mizushima
Hirofumi
H
Yamamoto
Mitsugu
M
Sekimoto
Yuichiro
Y
Doki
Masaki
M
Mor
D000368:Aged; D059248:Chemoradiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D012008:Recurrence; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000556:secondary / Q000601:surgery* / Q000628:therapy; D014057:Tomography, X-Ray Computed