Clinical Outcome of Salvage Surgery for Stage III Patients with Recurrent Colorectal Cancer

Abstract

Purpose. The aim of this study is to evaluate the survival benefits of salvage surgery as a treatment for recurrent colorectal cancer in stage Ⅲ patients. Methods. We reviewed 568 cases (treated in Chang Gung Memorial Hospital between 1996 and 2001) of stage Ⅲ colorectal cancer with recurrence (including metastasis) and analyzed the survival outcomes associated with salvage surgery. Resutls. The rate of salvage surgery was 30.3%. The 8-year overall and cancer-specific survival rates were higher in patients who had undergone salvage surgery than in those who had not (14.4% and 16.5% v.s. 5.0% and 5.1% respectively, p＜0.01). The resection of tumors resulted in long-term survival. The 8-year overall and cancer-specific survival rates were 57.0% and 57.0%, respectively in patients who had undergone lung metasectomy, 30.9% and 35.0%, respectively in those who had undergone liver metasectomy, and 5.0% and 7.1%, respectively in those who had undergone resection of intra-abdominal and pelvic tumor. No long-term survival was noted in patients who had undergone palliative procedures without tumor resection. Although the patients who underwent salvage surgery of lung metasectomy had the best long-term survival outcomes, followed by those who underwent liver metasectomy, however, the observed difference in survival rates between the two types of salvage surgery was not statistically significant. Conclusion. Salvage surgery improved the survival prospects of recurrent colorectal cancer patients. In fact, some patients were cured by salvage surgery. Early detection of tumor recurrence and the appropriate identification of patients requiring salvage surgery are predicted to improve the survival rate of stage Ⅲ patients with recurrent colorectal cancer.