title: Therapeutic management and outcome of locoregional recurrence after curative colorectal cancer therapy-a single-center analysis.
abstract: Locoregional tumor recurrence after curative therapy for colorectal cancer is therapeutically challenging and associated with poor prognosis. Goal of this single-center study was to analyze patients with locoregional recurrence with regard to therapeutic strategies and outcome for colon and rectal cancer each. Charts of all patients surgically treated for colorectal cancer in the period from 2000 to 2011 (n = 1296) were examined; patients with locoregional recurrence (n = 86) were then further analyzed. Fifty-three (10.2%) patients with rectal and 33 (5.6%) patients with colon cancer developed a locoregional recurrence, median 24.5 months after first diagnosis. Recurrence-specific therapy was applied in the majority of the patients (84.8% colon, 90.7% rectum); a surgical approach was undertaken in 82.1% (colon) and in 56.3% (rectum). Five-year overall survival after locoregional recurrence was 13% for rectal cancer and 9% for colon cancer. Itemized analysis for the approached therapeutic regimens revealed that radical recurrence resection (R0) significantly prolongs overall survival (p = 0.003) in rectal cancer, as does a surgical approach itself, as compared to conservative treatment modalities. If feasible, oncologic radical resection of the relapse (R0) significantly influences patient outcome and overall survival in rectal cancer.
authors.affiliation: Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Anichstrasse 35, A-6020, Innsbruck, Austria.
authors.forename: Pamela
authors.initials: P
authors.lastname: Kogler
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kafka-Ritsch
authors.forename: Michael
authors.initials: M
authors.lastname: Sieb
authors.forename: Arpad
authors.initials: A
authors.lastname: Sztankay
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.forename: Matthias
authors.initials: M
authors.lastname: Zitt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D059248:Chemoradiotherapy / Q000379:methods*; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis