title: [The possibilities of treatment of recurrent colorectal cancer with sacral invasion].
abstract: OBJECTIVE
  To describe current methods of surgical treatment of rare form of recurrent rectal cancer with sacral invasion.
  
  
  METHODS
  The article presents the methodology for the treatment of patients with recurrent colorectal cancer and sacral invasion using preoperative chemoradiotherapy followed by high-tech surgery of recurrent tumor removal with sacral resection at various levels (including high intersection at S1 level).
  
  
  CONCLUSIONS
  It was concluded that chemoradiotherapy is indicated in patients with recurrent colorectal cancer if it was not made at the first stage of treatment. Additional radiotherapy up to optimum overall focal dose prior to surgery is advisable in those patients who previously underwent radiotherapy with partial dose. This type of operations has high risk of complications and requires a personalized approach to the selection of patients. However, R0-resection is associated with favorable long-term prognosis, significantly increased survival and overall quality of life. Combined surgery for recurrent tumors with sacral invasion should be performed by multidisciplinary surgical team in specialized centers using current possibilities of anesthesiology and intensive care.
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: E R
authors.initials: ER
authors.lastname: Musaev
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: A V
authors.initials: AV
authors.lastname: Polynovsky
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: A O
authors.initials: AO
authors.lastname: Rasulov
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: V F
authors.initials: VF
authors.lastname: Tsaryuk
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: D V
authors.initials: DV
authors.lastname: Kuz'michev
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: E A
authors.initials: EA
authors.lastname: Sushentsov
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: S S
authors.initials: SS
authors.lastname: Balyasnikova
authors.affiliation: Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow.
authors.forename: D I
authors.initials: DI
authors.lastname: Safronov
mesh_terms: D000368:Aged; D059248:Chemoradiotherapy / Q000379:methods*; D003110:Colonic Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D003131:Combined Modality Therapy / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011788:Quality of Life; D012426:Russia / Q000453:epidemiology; D012445:Sacrococcygeal Region / Q000473:pathology / Q000601:surgery