Characteristics and Outcomes of Patients Who Underwent Curative Resection for Colorectal Cancer Local Recurrence.

Abstract

Background/aim: The standard treatment for local recurrence (LR) is radical resection where possible, and R0 resection is reportedly associated with improved prognosis. However, the surgery for LR is complex and difficult, resulting in a low resection rate of 13-23%. The aim of this study was to examine clinical characteristics of LR and survival outcome after R0 resection of LR.

Patients and methods: We retrospectively reviewed the medical records of 18 patients who underwent curative surgery for colorectal cancer LR at four hospitals between April 2016 and March 2024. We examined the perioperative outcomes and prognosis of LR treated with R0 resection.

Results: Pathological T4 was seen in 9 of 18 patients (50.0%), N-positive status in 12 (66.7%), and lymphovascular invasion in 15 (83.3%). Median interval from primary surgery to local recurrence was 24 months. Postoperative complications occurred in 9 patients (50.0%). Eight patients (44.4%) experienced re-recurrence, with peritoneal metastasis in 5 patients, liver metastasis in one, lung metastasis in one, and adrenal gland metastasis in one. Five-year RFS was 39.4% and 5-year OS was 52.2%.

Conclusion: Postoperative LR of colorectal cancer is expected to show relatively favorable prognosis with R0 resection. LR often occurs within 3 years, and careful follow-up is necessary for high-risk cases.