title: Unusual recurrent rectal carcinoma: a cancer field theory viewpoint.
abstract: OBJECTIVE
  The rate of rectal cancer locoregional recurrence following radical surgery varies from 4% to 33%. Though the causes are unclear, likely factors include microscopic tumor residues in the lymphatics, positive resection margins and exfoliation of tumor cells and their subsequent intraluminar spread during operation. Other significant factors include type and technique of surgical procedure. Recently, it has been demonstrated that local recurrence may also be associated with the biological behaviour of the tumor and/or with the composition of the cellular microenvironment which creates optimal conditions for the growth and spread of tumor cells.
  
  
  METHODS
  The presented case here is interesting because the tumour recurred early following a curative surgical procedure with negative resection margins, without positive lymph nodes, without infiltration of the pelvic wall and without distant metastases.
  
  
  CONCLUSIONS
  In patients with a determined risk of genetically altered tumor field encompassing epithelial or stromal changes, a different treatment strategy, including gene therapy, anti-inflammatory or anti-angiogenic therapy should be chosen to minimize increased tumor risk.
authors.affiliation: Department of Surgery I, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
authors.forename: Kamil
authors.initials: K
authors.lastname: Vyslouzil
authors.forename: Svetlana
authors.initials: S
authors.lastname: Brychtova
authors.forename: Pavel
authors.initials: P
authors.lastname: Zboril
authors.forename: Pavel
authors.initials: P
authors.lastname: Skalicky
authors.forename: Katherine
authors.initials: K
authors.lastname: Vomackova
authors.forename: Michala
authors.initials: M
authors.lastname: Bezdekova
authors.forename: Tomas
authors.initials: T
authors.lastname: Brychta
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D059016:Tumor Microenvironment