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Surgical treatment of locally recurrent rectal cancer: a narrative review

OBJECTIVE: To summarize the recent literature on surgical treatment of locally recurrent rectal cancer (LRRC). BACKGROUND: LRRC is a heterogeneous disease that requires a multidisciplinary treatment approach. The treatment and prognosis depend on the site and type of recurrence. Radical resection re...

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Detalles Bibliográficos
Autores principales: Gao, Zhaoya, Gu, Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8267292/
https://www.ncbi.nlm.nih.gov/pubmed/34277826
http://dx.doi.org/10.21037/atm-21-2298
Descripción
Sumario:OBJECTIVE: To summarize the recent literature on surgical treatment of locally recurrent rectal cancer (LRRC). BACKGROUND: LRRC is a heterogeneous disease that requires a multidisciplinary treatment approach. The treatment and prognosis depend on the site and type of recurrence. Radical resection remains the primary method for achieving long-term survival and improving symptom control. Preoperative chemoradiotherapy can reduce tumor volume and improve the R0 resection rate. Surgeons must clearly understand pelvic anatomy, develop a detailed preoperative plan, adopt a multidisciplinary approach for the surgical resection of the tumor as well as any invaded soft tissues, vessels, and bones, and ensure proper reconstruction. However, extended radical surgery often leads to a higher risk of postoperative complications and a low quality of life. METHODS: We searched English-language articles with keywords “locally recurrent rectal cancer”, “surgery” and “multidisciplinary team” in PubMed published between January 2000 to October 2020. CONCLUSIONS: LRRC is a complex problem. Long-term survival is not impossible following multidisciplinary treatment in appropriately selected LRRC patients. The management of LRRC relies on a specialist team that determines the biological behavior of the tumor and evaluates treatment options through multidisciplinary discussions, thereby balancing the surgical costs and benefits, alleviating postoperative complications, and improving patients’ quality of life.