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Recurrent Rectal Cancer

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Complexities in Colorectal Surgery

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Abstract

Following resection of a primary rectal cancer, tumor will recur within the pelvis at a rate of 4–33 %. Because uncontrolled pelvic recurrence can lead to disabling pain, bleeding, obstruction, infection, and mortality, an aggressive surgical approach should be considered when it can be performed with acceptable morbidity and mortality. Accurate assessment of resectability is critical, as obtaining negative surgical margins is the most significant prognostic factor for long-term survival. However, reoperative pelvic surgery is challenging, as the planes of dissection are disrupted and often infiltrated by tumor. Preoperative therapy, including chemotherapy and radiation, should be employed when possible to maximize tumor shrinkage and optimize complete resection. In this chapter, we discuss the diagnosis, evaluation, and multimodality management of locally recurrent rectal cancer and the associated outcomes.

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Authors and Affiliations

  1. Division of Surgery, Department of Colon and Rectal Surgery, Lahey Clinic, 41 Mall Road, Burlington, MA, 01805, USA

    Todd D. Francone MD, MPH

  2. Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10021, USA

    Martin R. Weiser MD

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  1. Todd D. Francone MD, MPH
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  2. Martin R. Weiser MD
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Correspondence to Martin R. Weiser MD .

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Editors and Affiliations

  1. Division of Colon and Rectal Surgery Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA, USA

    Scott R. Steele MD

  2. Division of Colorectal Surgery Department of Surgery, UMass Memorial Medical Center University of Massachusetts Medical School, Worcester, MA, USA

    Justin A. Maykel MD

  3. Division of Colon and Rectal Surgery Department of Surgery, Case Western Reserve University School of Medicine University Hospitals, Cleveland, OH, USA

    Bradley J. Champagne MD

  4. Division of Colon and Rectal Surgery Department of Surgery, Louisiana State University Health Science Center LSU School of Medicine, New Orleans, LA, USA

    Guy R. Orangio MD

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Francone, T.D., Weiser, M.R. (2014). Recurrent Rectal Cancer. In: Steele, S.R., Maykel, J.A., Champagne, B.J., Orangio, G.R. (eds) Complexities in Colorectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9022-7_15

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