ABSTRACT
The treatment of recurrent rectal cancer is a major challenge for surgeons, radiotherapists, and medical oncologists. In recent years, encouraging results have been reported with multimodality treatment. The goal of the present article is to outline strategies for the diagnosis and treatment of recurrent rectal cancer, based on data reported in the literature and our own experience. Following histologic confirmation, the pattern of recurrent disease and resectability are evaluated by a thorough preoperative diagnostic workup that includes clinical assessment, endoscopy, and imaging studies. Surgical treatment, tailored according to the pattern of pelvic recurrence, aims to achieve complete disease removal. However, when curative resection is infeasible, chemotherapy and preoperative or intraoperative radiotherapy are utilized in order to improve resectability rate and survival. A variety of different approaches have been proposed for the palliation of symptoms in patients with advanced local recurrent disease not amenable to multimodality treatment.
KEYWORD
Recurrent rectal cancer - multimodality treatment - surgery - radiotherapy - chemotherapy
