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Journal of the Korean Society of Coloproctology 2003;19(5):314-321.
Surgical Treatment of Recurrent Colorectal Cancer.
Koo, Gwang Mo , Park, Sang Su , Yoon, Jin , Kim, Il Myoung , Yu, Byoung Uk , Yang, Dae Hyun , Cho, Ik Hang
1Department of Surgery, Kangnam General Hospital Public Corporation, Korea. gspss@kangnamhosp.or.kr
2Department of Surgery, Pyung Chon Sacred Heart Hospital, College of Medicine, Hallym University, Korea.
3Department of Surgery, Dongbu Municipal Hospital, Seoul, Korea.
Abstract
PURPOSE
Recurrent colorectal cancers have important and difficult diagnostic and treatment problems. The purpose of this study is to evaluate the rationale and the efficacy of surgical re-treatment for patients with recurrence following curative surgery for colorectal cancer.
METHODS
From January 1991 to December 2002, we experienced 60 (20.9%) patients with recurred colorectal cancer among 287 patients who had curative operations in our hospital. These 60 patients were divided into three groups. Patients in group 1 had curative-intent resections, patients in group 2 had palliative resections, and patients in group 3 had conservertive treatment. The groups consisted of 17 (28.3%), 10 (16.7%) and 33 (55.0%) patients, respectively. We analyzed retrospectively those groups for any recurrence pattern and for survival.
RESULTS
Of the 60 patients with recurrent colorectal cancer, in 20 (33.3%) patients the cancer recurred in the colon, and in 40 (66.7%) it recurred in the rectum. Local recurrence was seen in 9 (15.0%) patients, liver metastasis in 25 (41.7%), and pulmonary metastasis in 13 (21.7%). The 1- and 3-, and 5-year survival rates were 86.5%, 31.7%, and 15.9%, respectively, for group 1, 33.3%, 0%, and 0% for group 2, and 28.9%, 4.4%, and 4.4% for group 3. The median survival period was 31 months for group 1, 8 months for group 2, and 7 months for group 3.
CONCLUSIONS
Although evaluation was difficult owing to the small number of patients with recurrent colorectal cancer, a significant difference in survival rates was observed between the treatment groups. On the basis of these results, we think that curative-intent aggressive surgery for recurrent colorectal cancer in appropriately selected cases can clearly prolong survival when compared with palliative resections and conservative treatment.
Key Words: Colorectal Neoplasm, Survival rate, Neoplasm recurrent, Local


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