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Follow-Up Strategy After Primary and Early Diagnosis

  • Aldo InfantinoEmail author
  • Andrea Lauretta
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

Recurrent disease following colorectal cancer surgery will occur in about 30–50% of patients when considering both locoregional relapse and distant metastasis [1]. Rectal cancer is associated more frequently with local failure than is colon cancer due to its distinctive behavior of spreading to the pelvis through the lymphatic and venous system. However, the introduction of total mesorectal excision (TME) and the association of neoadjuvant radiochemotherapy have dramatically reduced the local relapse rate to 6% [2]. Anastomotic recurrence is recorded in 5–15% of patients [3], even though it should be considered that the recurrent disease most often begins extraluminally, especially in the presacral area, and less frequently in the anastomotic area [4]. Curative treatment of recurrence is possible, and this improves prognosis and overall survival. However, salvage surgery in patient with pelvic recurrence can be performed only in 30–40% of cases, with morbidity and mortality rates, respectively, up to 44% and 6% [5, 6, 7, 8]. Given the high risk of recurrence, both locoregional and distant, and the dismal prognosis of patient with disease relapse, the importance of follow-up programs for early recurrent cancer detection is clear.

Keywords

National Comprehensive Cancer Network National Comprehensive Cancer Network Salvage Surgery Anastomotic Recurrence Colorectal Cancer Recurrence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer-Verlag Italia 2016

Authors and Affiliations

  1. 1.General Surgery UnitSanta Maria dei Battuti HospitalSan Vito al Tagliamento, PordenoneItaly

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