Improved long-term salvage potential of locally recurrent rectal cancer with evolving multimodality therapy

摘要: BackgroundThe practice of salvaging recurrent rectal cancer has evolved. Among patients with locally-recurrent disease, we aimed to define their evolving salvage potential over time, and to identify durable determinants of long-term success.MethodsIn consecutive patients undergoing curative-intent multimodality salvage between 1988–2012, predictors of long-term survival were defined by Cox regression analysis and compared over time. Re-recurrence and subsequent treatments were evaluated.ResultsAfter multi-disciplinary evaluation of 229 patients, curative-intent salvage therapy included preoperative chemotherapy and/or radiation (74%, with 41% undergoing repeat pelvic irradiation), surgical salvage resection with/without intraoperative radiation (83 patients, 36%), followed by postoperative adjuvant chemotherapy (87, 38%). Curative-intent resection involved multi-visceral resection in 47% and bone …