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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2007

01-03-2007

Resection of Isolated Pelvic Recurrences After Colorectal Surgery: Long-Term Results and Predictors of Improved Clinical Outcome

Authors: Leonard R. Henry, MD, Elin Sigurdson, MD, PhD, Eric A. Ross, PhD, John S. Lee, MD, James C. Watson, MD, Jonathan D. Cheng, MD, Gary M. Freedman, MD, Andre Konski, MD, John P. Hoffman, MD

Published in: Annals of Surgical Oncology | Issue 3/2007

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Abstract

Background

Recurrence in the pelvis after resection of a rectal or rectosigmoid cancer presents a dilemma. Resection offers the only reasonable probability for cure, but at the cost of marked perioperative morbidity and potential mortality. Clinical decision making remains difficult.

Methods

Patients who underwent resection with curative intent for isolated pelvic recurrences after curative colorectal surgery from 1988 through 2003 were reviewed retrospectively. Clinical and pathological factors, salvage operations, and complications were recorded. The primary measured outcome was overall survival. Univariate and multivariate analyses were conducted to identify prognostic factors of improved outcome.

Results

Ninety patients underwent an attempt at curative resection of a pelvic recurrence; median follow-up was 31 months. Complications occurred in 53% of patients. Operative mortality occurred in 4 (4.4%) of 90 patients. Median overall survival was 38 months, and estimated 5-year survival was 40%. A total of 51 of 86 patients had known recurrences (15 local, 16 distant, 20 both). Multivariate analysis revealed that preoperative carcinoembryonic antigen level and final margin status were statistically significant predictors of outcome.

Conclusions

The resection of pelvic recurrences after colorectal surgery for cancer can be performed with low mortality and good long-term outcome; however, morbidity from such procedures is high. Low preoperative carcinoembryonic antigen and negative margin of resection predict improved survival.
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Metadata
Title
Resection of Isolated Pelvic Recurrences After Colorectal Surgery: Long-Term Results and Predictors of Improved Clinical Outcome
Authors
Leonard R. Henry, MD
Elin Sigurdson, MD, PhD
Eric A. Ross, PhD
John S. Lee, MD
James C. Watson, MD
Jonathan D. Cheng, MD
Gary M. Freedman, MD
Andre Konski, MD
John P. Hoffman, MD
Publication date
01-03-2007
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9266-7

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