Abdominosacral resection for locoregional recurrence rectal cancer]

Local recurrence of rectal cancer occurs in up to 30% after radical surgical treatment and it represents a formidable challenge to surgeons and oncologist, presenting most of times within two years after proper therapy have been provided. Although chemoradiation therapy reduces the rate of it, it has no any impact in survival. On the other hand, it has been proved that almost 50% of recurrences are without evidence of systemic disease and amenable to surgical resection, by the time of diagnose. For this reason there are a number of authors currently arguing a more agressive treatment for this entity in order to improve survival and reduces recurrence rate. Radical pelvic surgery for recurrent rectal cancer should be performed primarily with curative intent in patients without evidence of extrapelvic or distant spread. Abdominosacral resection represents a therapeutic option for patients with specific type of pelvic recurrence providing, according to figures from the most experienced groups, an actuarial survival rates of almost 33% at four years in a group of patients with a life expectancy, by other means, round seven months. We present our experience with this surgical procedure in Surgical Oncology Department at Roger Williams Cancer Center in Providence, leads by HJ. Wanebo.