title: Early and Late Outcomes of Surgery for Locally Recurrent Rectal Cancer: A Prospective 10-Year Study in the Total Mesorectal Excision Era.
abstract: OBJECTIVE
  The aim of this study was to assess the outcome of all locally recurrent rectal cancer (LRRC) patients who were referred to a tertiary care center. The study examined LRRC patients who underwent surgery after prior total mesorectal excision.
  
  
  METHODS
  The data of 213 consecutive LRRC patients who were registered in a database between 2001 and 2010 were accessed.
  
  
  RESULTS
  A total of 115 patients (54 %) with a median age of 63 (range 34-81) years underwent tumor resection. The 30-day mortality rate was 0.8 % (95 % CI 0.02-4 %), and the complication rate was 42 % (95 % CI 33-51 %). R0 resection was achieved in 70 patients (61 %), R1 resection in 38 patients (33 %), and R2 resection in 7 patients (6 %). The 3- and 5-year survival rates for R0 resections were 55 % (95 % CI 41-66) and 40 % (95 % CI 26-53), respectively; 42 % (95 % CI 26-58) and 16 % (95 % CI 5-31), respectively, for R1 resections; no patients who received an R2 resection survived to the 3-year mark. Patients with prior abdominoperineal excision (APE) had significantly poorer survival rates than patients with prior resection with anastomosis (p = 0.02).
  
  
  CONCLUSIONS
  Acceptable long-term survival can be achieved for patients undergoing surgery for LRRC, but radical resection is mandatory. Prior APE was associated with poorer survival rates.
authors.affiliation: Department of Surgery, Aarhus University Hospital, Tage-Hansens Gade 2, 8000, Aarhus, Denmark, mettebaknielsen@stofanet.dk.
authors.forename: Mette
authors.initials: M
authors.lastname: Nielsen
authors.forename: Peter
authors.initials: P
authors.lastname: Rasmussen
authors.forename: Bodil
authors.initials: B
authors.lastname: Pedersen
authors.forename: Rikke
authors.initials: R
authors.lastname: Hagemann-Madsen
authors.forename: Jacob
authors.initials: J
authors.lastname: Lindegaard
authors.forename: Søren
authors.initials: S
authors.lastname: Laurberg
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D018365:Neoplasm, Residual; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome