Skip to main content

Abstract

Local recurrence (LR) after curative surgery is a critical problem for patients with colorectal cancer (CRC). Over the last two decades, oncologic treatment results for primary rectal cancer have improved due to refinements in neoadjuvant chemotherapy, radiation, and surgery. Nevertheless, there is still a 5–10% rate of LR, threatening the survival and quality of life of affected patients [1]. LR is best defined as any tumor recurring within the true pelvis, including neorectum, mesentery, pelvic viscera, pelvic sidewall structures, and bone. Due to variability of anatomy and clinical presentation, detection, staging, and clinical management are complex. About half of all LRs are limited to the pelvis and can be considered for curative re-excision [2] (Table 6.1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Heriot AG, Byrne CM, Lee P et al (2008) Extended radical resection: the choice for locally recurrent rectal cancer. Dis Colon Rectum 51:284–291

    Article  PubMed  Google Scholar 

  2. Heald RJ (1995) Total mesorectal excision is optimal surgery for rectal cancer: a Scandinavian consensus. Br J Surg 82:1297–1299

    Article  CAS  PubMed  Google Scholar 

  3. Guillem JG, Chessin DB, Cohen AM et al (2005) Longterm oncologic outcome following pre-operative combined modality therapy and total mesorectal excision of locally advanced rectal cancer. Ann Surg 241:829 (discussion 836–828)

    Article  PubMed Central  PubMed  Google Scholar 

  4. Wanebo HJ, Antoniuk P, Koness RJ et al (1999) Pelvic resection of recurrent rectal cancer: technical considerations and outcomes. Dis Colon Rectum 42:1438-1448

    Article  CAS  PubMed  Google Scholar 

  5. Heriot AG, Byrne CM, Lee P et al (2008) Extended radical resection: the choice for locally recurrent rectal cancer. Dis Colon Rectum 51:284-291

    Article  PubMed  Google Scholar 

  6. Yamada K, Ishizawat T, Niwa K et al (2001) Patterns of pelvic invasion are prognostic in the treatment of locally recurrent rectal cancer. Br J Surg 88:988-993

    Article  CAS  PubMed  Google Scholar 

  7. Jimenez RE, Shoup M, Cohen AM et al (2003) Contemporary outcomes of total pelvic exenteration in the treatment of colorectal cancer. Dis Colon Rectum 46:1619-1625

    Article  PubMed  Google Scholar 

  8. Yeo HL, Paty PB (2014) Management of Recurrent Rectal Cancer: Practical Insights in Planning and Surgical Intervention. J Surg Onc 109:47-52

    Article  Google Scholar 

  9. Bouchard P, Efron J (2010) Management of recurrent rectal cancer. Ann Surg Oncol 17:1343–1356

    Article  PubMed  Google Scholar 

  10. Primrose JN, Perera R et al (2014) Effect of 3 to 5 years of scheduled CEA and follow-up to detect recurrence of colorectal cancer. The FACS randomized clinical trial. JAMA 311:263-270

    Article  CAS  PubMed  Google Scholar 

  11. Platell C, Spilsbury K (2014) Influence of local recurrence on survival in patients with rectal cancer. ANZ J Surg 84:85–90

    Article  PubMed  Google Scholar 

  12. Sagar PM, Pemberton JH (1996) Surgical management of locally recurrent rectal cancer. Br J Surg 83:293–304

    Article  CAS  PubMed  Google Scholar 

  13. Lopez-Kostner F, Fazio VW et al (2001) Locally recurrent rectal cancer: predictors and success of salvage surgery. Dis Colon Rectum 44:173–178

    Article  CAS  PubMed  Google Scholar 

  14. Mirnezami AH, Sagar PM et al (2010) Clinical algorithms for the surgical management of locally recurrent rectal cancer. Dis Colon Rectum 53:1248–1257

    Article  PubMed  Google Scholar 

  15. Harris DA, Davies M et al (2011) Multivisceral resection for primary locally advanced rectal carcinoma. Br J Surg 98:582–588

    Article  CAS  PubMed  Google Scholar 

  16. Nordlinger B et al (2008) Perooperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomized controlled trial. Lancet 371:1007–1016

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Haddock MG, Miller RC et al (2011) Combined modality therapy including intraoperative electron irradiation for locally recurrent colorectal cancer. Int J Radiat Oncol Biol Phys 79:143–150

    Article  PubMed  Google Scholar 

  18. Heinemann V, von Weikersthal L, Decker T et al (2013) FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): a randomised, open-label, phase 3 trial. J Clin Oncol 31(suppl)

    Google Scholar 

  19. Loupakis F, Cremolini C et al (2014) Initial therapy with FOLFOXIRI and Bevacizumab for metastatic colo rectal cancer. N Engl J Med 371:1609–1618

    Article  PubMed  Google Scholar 

  20. Falcone A, Cremolini C, Masi G et al (2013) FOLFOXIRI/bevacizumab (bev) versus FOLFIRI/bev as first-line treatment in unresectable metastatic colorectal cancer (mCRC) patients (pts): results of the phase III TRIBE trial by GONO group (abstract 3505). J Clin Oncol 31(suppl)

    Google Scholar 

  21. Lee S. Schwartzberg et al (2013) PEAK: a randomized, multicenter phase ii study of panitumumab plus modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) or bevacizumab plus mFOLFOX6 in patients with previously untreated, unresectable, wild-type KRAS Ex-on 2 metastatic colorectal cancer. J Clin Oncol 32:2240–2247

    Google Scholar 

  22. Van Cutsem E, Cervantes A, Nordlinger B, Arnold D; ESMO Guidelines Working Group (2014) Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25(Suppl 3):iii1–iii9

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rosario V. Iaffaioli .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag Italia

About this chapter

Cite this chapter

Nappi, A. et al. (2016). Indications for Systemic Chemotherapy. In: Romano, G.M. (eds) Multimodal Treatment of Recurrent Pelvic Colorectal Cancer. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5767-8_6

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5767-8_6

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5766-1

  • Online ISBN: 978-88-470-5767-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics