Management of Locally Advanced and Recurrent Rectal Cancer



The management of locally advanced primary rectal cancer and locally recurrent rectal cancer is challenging. The fundamental principle in the management of these cancers resides in complete en bloc resection with a clear resection margin. In appropriately selected cases, 5 year survivals of 50 % have been reported. The management of rectal cancers, particularly that of locally advanced primary rectal cancer or locally recurrent rectal cancer has evolved to become a subspecialty within colorectal surgery. Despite the established role of pelvic exenteration for locally recurrent rectal cancers, it is somewhat disappointing that most patients who develop local recurrence are not being considered for onward referral for consideration of pelvic exenteration. This chapter provides an overview of the management of patients with locally advanced and recurrent rectal cancer but also highlights some of the contentious issues surrounding patient selection for surgery and modern breakthroughs in the surgical approach.


Rectal cancer Locally advanced rectal cancer Recurrent rectal cancer Pelvic exenteration Local recurrence Multi-visceral resection Extended radical resection Abdomino-sacral resection R0 


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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Royal Prince Alfred HospitalCamperdownAustralia
  2. 2.Surgical Outcomes Research Centre (SOuRCe)CamperdownAustralia
  3. 3.Discipline of SurgeryUniversity of SydneyNewtownAustralia

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