Annals of Surgical Oncology

, Volume 14, Issue 7, pp 2000–2009 | Cite as

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

  • Leonard R. Henry
  • Elin Sigurdson
  • Eric A. Ross
  • John S. Lee
  • James C. Watson
  • Jonathan D. Cheng
  • Gary M. Freedman
  • Andre Konski
  • John P. Hoffman
Article

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 perioperative morbidity and potential mortality. Clinical decision making remains difficult.

Methods

Patients resected with curative intent for isolated pelvic recurrences after curative colorectal surgery from 1988 through 2003 were reviewed retrospectively. Clinical and pathologic 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 with median follow-up of 31 months. Complications occurred in 53% of patients. Operative mortality was 4.4% (4 of 90). 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.

Keywords

Colorectal cancer Pelvis Recurrence Resection 

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Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • Leonard R. Henry
    • 1
  • Elin Sigurdson
    • 1
  • Eric A. Ross
    • 2
  • John S. Lee
    • 1
  • James C. Watson
    • 1
  • Jonathan D. Cheng
    • 3
  • Gary M. Freedman
    • 4
  • Andre Konski
    • 4
  • John P. Hoffman
    • 1
  1. 1.Department of Surgical OncologyFox Chase Cancer CenterPhiladelphiaUSA
  2. 2.Department of BiostatisticsFox Chase Cancer CenterPhiladelphiaUSA
  3. 3.Fox Chase Cancer CenterPhiladelphiaUSA
  4. 4.Department of Radiation OncologyFox Chase Cancer CenterPhiladelphiaUSA

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