Detection and Treatment of Local Recurrence of Rectal Cancer: From the Point of View of Pelvic Invasive Type

Kazutaka Yamada, Shigeya Hase, Kiyoshi Niwa, Takashi Sameshima, Jun'ichiro sameshima, Kouichi Arimura, Yutaka Tyuman, Yuji Takebayashi, Kanehiro Matsushita, Fujirou Kinoshita, Takashi Ishizawa, Takashi Aikou

First Department of Surgery, Kagoshima University School of Medicine

We classified 46 patients with local recurrence following resection of rectal cancer into three groups according to pelvic invasive pattern: lateral invasive type (29 cases; 63%),sacral invasive type (8 cases; 17%) and localized type (9 cases; 20%). Clinicopathological findings at the initial operation and period until recurrence were not significantly different between the types. The serum CEA value of all patients with the lateral and sacral invasive types was more than 2.5 ng/dl; however, 38% of patients with the localized type had that CEA level. Recurrent lesions in the loealized type were diagnosed by symptoms of organ invasion in 7 patients and found by periodic image diagnosis in 2 asymptomatic patients. Rates of radical resection per number of cases were 0% in the lateral invasive type, 50% in the sacral invasive type and 100% in the localized type; these rates were significantly different. Survival after recurrence of the localized type was significantly longer than that of the other types. Moreover, survival of 13 patients with radical resection for local reccurrent tumor was significantly longer than that of 13 patients with non-radical resection. These results suggested that the mode of local recurrence influenced prognosis. In particular, the resection for recurrence of the lateral invasive type did not contribute to survival.

Key words
local recurrence of the rectal cancer, total peivic exenteration, pelvic invasive type

Reprint requests
Kazutaka Yamada First Department of Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
April 13, 1994

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