Recent Modalities in Management of Locally Recurrent Rectal Carcinoma

Abstract

Surgery for LRRC is complex and often extensive, which may result in a significant degree of postoperative mortality and complications. However, 30-day mortality is reported to be low and is mainly caused by bleeding, sepsis and thromboembolic complications. Pelvic collections, perineal wound breakdown and wound infections accounted for more than half of all complications. Patients with unresectable lesions or unfit for operations are treated with chemotherapy with or without radiation according to their ability to tolerate therapy. Debulking that results in gross residual cancer is not recommended. Median survival for metastatic colorectal cancer without systemic chemotherapy ranges from 6 to 9 months. The addition of 5-FU-based regimens improves survival to 10 to 12 months. The addition of irinotecan or oxaliplatin to 5-FU further improves survival to 14 to 17 months. The addition of the monoclonal antibodies have improved median survival to greater than 20 months. Keywords: Lymphovascular invasion- Multidisciplinary Team- Mesorectal microfoci- Microsatellite instability