- •There is no consensus in the optimum management of LRRC.
- •Systematic review which included fifteen studies of 974 patients.
- •Improved resection status, local control and survival with neoadjuvant CRT.
- •General trend towards multimodality treatment over time for LRRC.
Abbreviations:CRT (chemoradiotherapy), LRRC (locally recurrent rectal cancer)
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Cancer Treatment Reviews
- Cancer statistics 2015.CA Cancer J Clin. 2015; 65: 5-29
- Neoadjuvant Therapy for Locally Advanced Rectal Cancer: Recent Advances and Ongoing Challenges.Clin Colorectal Cancer. 2021; 20: 29-41
- Locally advanced rectal cancer: management challenges.Onco Targets Ther. 2016; 9: 6265-6272
- Total mesorectal excision in the operative treatment of carcinoma of the rectum.J Am Coll Surg. 1995; 181: 335-346
- Total mesorectal excision is optimal surgery for rectal cancer: A Scandinavian consensus.Br J Surg. 1995; 82: 1297-1299
- Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm.Lancet. 2002; 356: 93-96
- Total Neoadjuvant Therapy (TNT) versus Standard Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis.Oncologist. 2021; 26: e1555-e1566
- Total Neoadjuvant Therapy in Rectal Cancer: A Systematic Review and Meta-analysis of Treatment Outcomes.Ann Surg. 2020; 271: 440-448
- Neoadjuvant chemoradiation for locally advanced rectal cancer: a systematic review of the literature with network meta-analysis.Cancer Manag Res. 2019; 11: 741-758
- Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer: a systematic review and meta-analysis.Int J Cancer. 2009; 124: 2966-2972
- Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer.N Engl J Med. 2001; 345: 638-646
- Treatment of locally recurrent rectal carcinoma in previously (chemo)irradiated patients: a review.Dis Colon Rectum. 2016; 59: 148-156
- Intraoperative radiation therapy with the photon radiosurgery system in locally advanced and recurrent rectal cancer: retrospective review of the Cleveland clinic experience.Radiat Oncol. 2012; 7: 110
- Long-Term Outcomes and Prognostic Analysis of Computed Tomography-Guided Radioactive 125I Seed Implantation for Locally Recurrent Rectal Cancer After External Beam Radiotherapy or Surgery.Front Oncol. 2021; 10540096
- A population-based study on the management and outcome in patients with locally recurrent rectal cancer.Ann Surg Oncol. 2007; 14: 447-454
- Non-operative treatment after neoadjuvant chemoradiotherapy for rectal cancer.Lancet Oncol. 2007; 8: 625-633
- Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC CTG C016): a multicentre, randomised trial.Lancet. 2009; 373: 811-820
- Meta-analysis of survival based on resection margin status following surgery for recurrent rectal cancer.Colorectal Dis. 2012; 14: 1457-1466
- Surgery for recurrent rectal cancer: higher and wider?.Colorectal Dis. 2013; 15: 139-145
- Ultraradical resection for locally recurrent rectal cancer.Dis Colon Rectum. 2014; 57: 1-2
- Outcome in patients with resectable locally recurrent rectal cancer after total mesorectal excision with and without previous neoadjuvant radiotherapy for the primary rectal tumor.Ann Surg Oncol. 2013; 21: 520-526
- Surgery for locally recurrent rectal cancer in the era of total mesorectal excision: is there still a chance for cure?.Ann Surg. 2011; 253: 522-533
- Significance of local recurrence of rectal cancer as a local or disseminated disease.Br J Surg. 1998; 85: 521-525
- Abdominosacral resection for primary irresectable and locally recurrent rectal cancer.Dis Colon Rectum. 2001; 44: 806-814
Farouk R, Nelson H, Radice E, Mercill S, Gunderson L. Accuracy of computed tomography in determining respectability for locally advanced primary or recurrent colorectal cancer. Am J Surg. 1998;175:283–87.
Akasu T, Yamaguchi T, Fujimoto Y, Ishiguro S, Yamamoto S, Fujita S et al. Abdominal Sacral Resection for posterior pelvic recurrence of rectal carcinoma: Analyses of prognostic factors and recurrence patterns. Ann Surg Oncol. 2007;14:74–8.
- Locally recurrent rectal cancer; Predictors and success of salvage surgery.Dis Colon Rectum. 2001; 44: 173-178
- Treatment of locally recurrent rectal cancer.Dis Colon Rectum. 2001; 44: 1743-1748
- Surgical salvage of recurrent rectal carcinoma after curative resection: a 10-year experience.Ann Surg Oncol. 1999; 6: 171-177
- Preoperative infusional chemoradiation, selective intraoperative radiation, and resection for locally advanced pelvic recurrence of colorectal adenocarcinoma.Ann Surg. 1996; 223: 177-185
- Management of recurrent rectal cancer: practical insights in planning and surgical intervention.J Surg Oncol. 2014; 109: 47-52
- Recurrent pelvic surgery.Surg Clin North Am. 2013; 93: 199-215
- Current management of locally recurrent rectal cancer.Colorectal Dis. 2011; 13: 732-742
- Management of recurrent rectal cancer.Ann Surg Oncol. 2010; 17: 1343-1356
Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N. Engl. J. Med. 2004;351:1731–40.
- Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3–4 rectal cancers: results of FFCD 9203.J Clin Oncol. 2006; 24: 4620-4625
- Chemoradiation with or without intraoperative radiation therapy in patients with locally recurrent rectal carcinoma: prognostic factors and long term outcome.Cancer. 1999; 86: 2612-2624
- Surgery for locally recurrent rectal cancer.Colorectal Dis. 2003; 5: 504-507
- Clinical nature and prognosis of locally recurrent rectal cancer after total mesorectal excision with or without preoperative radiotherapy.J Clin Oncol. 2004; 22: 3958-3964
- Salvage surgery for locally recurrent rectal cancer: total mesorectal excision during the primary operation does not influence the outcome.Colorectal Dis. 2011; 13: 506-511
- Hyperfractionated accelerated radiotherapy for rectal cancer in patients with prior pelvic irradiation.Int J Radiat Oncol Biol Phys. 2010; 77: 60-65
- Study Group for Therapies of Rectal Malignancies (STORM). Preoperative hyperfractionated chemoradiation for locally recurrent rectal cancer in patients previously irradiated to the pelvis: a multicentric phase II study.Int J Radiat Oncol Biol Phys. 2006; 64: 1129-1139
- Reirradiation to the pelvis for recurrent rectal cancer.J Surg Oncol. 2012; 105: 637-642
- Reirradiation, surgery and IORT for recurrent rectal cancer in previously irradiated patients.Radiother Oncol. 2008; 87: 357-360
- Predictors of survival in recurrent rectal cancer after resection and intraoperative radiotherapy.Dis Colon Rectum. 2002; 45: 585-592
- Intraoperative irradiation after surgery for locally recurrent rectal cancer.Dis Colon Rectum. 1999; 42: 886-893
- Efficacy and toxicity of rectal cancer reirradiation using IMRT for patients who have received prior pelvic radiation therapy.Advances in Radiation Oncology. 2016; 1: 94-100
- Accelerated hyperfractionated intensity-modulated radiotherapy for recurrent/unresectable rectal cancer in patients with previous pelvic irradiation: results of a phase II study.Radiat Oncol. 2014; 9: 278
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.Int J Surg. 2010; 8: 336-341
Higgins JPT, Green S, Chandler J. Cochrane Handbook for Systematic Reviews of Interventions, Version 6 (updated July 2019). Cochrane. 2019. Available from: www.training.cochrane.org/handbook.
Wells G, Shea B, O’Connell D. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2013. Available from: http:// www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
- Curative potential of multimodality therapy for locally recurrent rectal cancer.Ann Surg. 2003; 237: 502-508
- Surgery and pre-operative irradiation for locally advanced or recurrent rectal cancer in patients over 75 years of age.Colorectal Dis. 2006; 8: 177-185
- Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer.Radiother Oncol. 2001; 58: 83-87
- Preoperative radiotherapy improves outcome in recurrent rectal cancer.Dis Colon Rectum. 2005; 48: 918-928
- Total pelvic exenteration for primary locally advanced and locally recurrent rectal cancer.Eur J Surg Oncol. 2007; 33: 452-458
- Pelvic resection of recurrent rectal cancer: technical considerations and outcomes.Dis Colon Rectum. 1999; 42: 1438-1448
- Extensive surgery after high-dose preoperative chemoradiotherapy for locally advanced recurrent rectal cancer.Dis Colon Rectum. 2000; 43: 312-319
- Patterns of pelvic invasion are prognostic in the treatment of locally recurrent rectal cancer.Br J Surg. 2001; 88: 988-993
- Re-Irradiation in Patients with Recurrent Rectal Cancer is Safe and Feasible.Ann Surg Oncol. 2021; 28: 5194-5204
- Radical resection after IORT-containing multimodality treatment is the most important determinant for outcome in patients treated for locally recurrent rectal cancer.Ann Surg Oncol. 2008; 15: 1937-1947
- Neoadjuvant (re)chemoradiation for locally recurrent rectal cancer: Impact of anatomical site of pelvic recurrence on long-term results.Surg Oncol. 2020; 35: 89-96
- Preoperative irradiation and surgery for local recurrence of rectal and rectosigmoid cancer. Prognostic factors with regard to survival and further local recurrence.Colorectal Dis. 2008; 10: 48-57
- Curative surgery for local pelvic recurrence of rectal cancer.Dig Surg. 2003; 20: 192-200
- Curative surgical resection following reirradiation for recurrent rectal cancer.Int J Radiat Oncol Biol Phys. 1997; 39: 643-649
- Comparison of intraoperative radiation therapycontaining multimodality treatment with historical treatment modalities for locally recurrent rectal cancer.Dis Colon Rectum. 2001; 44: 1749-1758
- Management and prognosis of locally recurrent rectal cancer-a national population-based study.Eur J Surg Oncol. 2018; 44: 100-107
- Three-dimensional conformal radiotherapy combined with FOLFOX4 chemotherapy for unresectable recurrent rectal cancer.World J Gastroenterol. 2006; 12: 2610-2614
- Intentionally curative treatment of locally recurrent rectal cancer: a systematic review.Can J Surg. 2013; 56: 135-144
- Chemoradiotherapy response in recurrent rectal cancer.Cancer Med. 2014; 3: 111-117
- Predictors of successful salvage surgery for local pelvic recurrence of rectosigmoid colon and rectal cancers.Surg Today. 2007; 37: 853-859
- Improved Long-term Salvage Potential of Locally Recurrent Rectal Cancer with Evolving Multimodality Therapy.Br J Surg. 2016; 103: 753-762
- IMPACT collaborative. Making an IMPACT: A priority setting consultation exercise to improve outcomes in patients with locally advanced, recurrent and metastatic colorectal cancer.Eur J Surg Oncol. 2019; 45: 1567-1574
- Contemporary Management of Locally Advanced and Recurrent Rectal Cancer: Views from the PelvEx Collaborative.Cancers (Basel). 2022; 14: 1161
PelvEx Collaborative. Induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as neoadjuvant treatment for locally recurrent rectal cancer: study protocol of a multicentre, open-label, parallel-arms, randomized controlled study (PelvEx II). BJS Open. 2021;5(3):zrab029.
Denost Q, Frison E, Salut C, Sitta R, Rullier A, Harji et al. on behalf of the GRECCAR Group. A phase III randomized trial evaluating chemotherapy followed by pelvic reirradiation versus chemotherapy alone as preoperative treatment for locally recurrent rectal cancer - GRECCAR 15 trial protocol. Colorectal Dis. 2021;23(7):1909-18.
- Systematic review of classification systems for locally recurrent rectal cancer.BJS Open. 2021;5(3):zrab024;
- Radicality of resection and survival after multimodality treatment is influenced by subsite of locally recurrent rectal cancer.Int J Radiat Oncol Biol Phys. 2009; 75: 1444-1449
- Prognostic factors affecting oncologic outcomes in patients with locally recurrent rectal cancer: impact of patterns of pelvic recurrence on curative resection.Langenbecks Arch Surg. 2009; 394: 71-77