Locally recurrent rectal cancer: treatment options

Abstract

Background. Although the preoperative radiochemotherapy and the optimised surgical technique have improved the outcome in patients with rectal cancer, the local recurrence still remains a therapeutic problem. In up to 50% of patients the local recurrence appears without simultaneous distant metastases. This review highlights current treatment options of locally recurrent rectal cancer. Conclusions. The optimal management of the isolated local recurrence remains a difficult and controversial issue. The radical surgical resection is the mainstay of the curative treatment, but an extended surgery can be associated with significant morbidity and impaired quality of life. The preoperative chemoradiation for turnout down staging increases the chance of resectability and the addition of intraoperative radiotherapy may further improve the local control and survival. Re-irradiation is feasible in patients who already received irradiation as part of the primary rectal cancer treatment.