e14132 Background: Complete surgical resection is considered the best treatment for recurrent rectal cancer (RRC). The aim of the study was to compare survival outcomes from operative and non-operative patients presenting with RRC. Methods: Patients with RRC whose management was discussed by a tertiary referral specialist multidisciplinary team between January 2007 and August 2011 were identified from a prospectively maintained database. The primary endpoint was 5-year overall survival estimated by Kaplan-Meier survival method. Results: Of 127 patients with RRC, 105 were isolated to the pelvis and 22 were associated with distant disease at presentation. From the time of primary surgery to first recurrence, 1, 3, 5 and 10-year local recurrence rates were 22%, 72%, 85% and 96% respectively. Of 70 patients (55%, 70/127) who underwent pelvic resection of recurrence, 64% underwent R0, 20% R1 and 16% R2 resections. Corresponding 5-year overall survival was R0: 60%, R1: 42% and R2: 0% (log-rank p=0.004). There was no significant difference in survival between R2 resection and those managed non-operatively (hazard ratio 0.738, 95% confidence interval 0.341-1.600, p=0.559). Five year disease-free survival was 53% with R0 resection and 30% with R1 resection. Conclusions: Most recurrences occur within 5 years of primary surgery, although some occur up to 10 years later. R0 resection is the treatment of choice that leads to long-term survival and is suitable as an early surrogate marker for long-term survival. There was no survival benefit of R2 resection over non-resected recurrences.
Long-term survival outcomes of laparoscopic extralevator abdominoperineal excision for low rectal cancer in a single center, high volume unit
