Surg Today (2004) 34:907–912 DOI 10.1007/s00595-004-2816-3 Potentially Curative Resection for Locoregional Recurrence of Colorectal Cancer Mehmet Fuzun 1 , Cem Terzi 1 , Selman Sokmen 1 , Tarkan Unek 1 , and Mehmet Haciyanli 2 1 Department of Surgery, Colorectal Surgery Unit, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey 2 Second Department of Surgery, Izmir Atatürk Training and Research Hospital, Izmir, Turkey Introduction The prognosis and long-term survival of patients with colorectal carcinoma is dependent on two factors: the nature of the malignancy and the stage of the disease. Up to one third of patients have locally advanced or metastatic disease at the time of diagnosis, which precludes surgical cure. The remaining two thirds un- dergo potentially curative resection, but nearly half of these patients will suffer recurrence and die within 5 years. 1 The most common sites of recurrence are the liver (25%), lungs (20%), and abdomen or pelvis (25%–30%). 2,3–5 Locoregional recurrence (LRR), which is defined as recurrence in the tumor bed, regional nodes, adjoining structures, anastomosis, pelvis, perineum, and surgical scars, is responsible for about 30% of deaths. 3 Locoregional recurrence can range from small isolated failures in the anastomosis to diffuse involvement of the peritoneal cavity, pelvis, or abdominal wall. 6 According to a number of reports, LRR is associated with perito- neal, metastatic, or plurimetastatic deposits in 70%–90% of patients. 3,4,7 There is no standard treat- ment for LRR of colorectal cancer, but depending on the primary treatment, many treatments, including surgery, external beam radiotherapy, intraoperative radiotherapy, systemic chemotherapy, locoregional chemotherapy, or combinations of these have been used. Chemotherapy alone or combined with radio- therapy can provide temporary relief of symptoms. 8–10 Similarly, surgical resection, although not always cura- tive, can provide good palliation of pain, obstruction, perforation, bleeding, and sepsis. For patients with re- currence after curative surgery for colorectal cancer, the choice of therapy is between nonsurgical palliative mo- dalities and radical surgery. 2,3,5,11,12 Active reoperation with grossly complete resection is indicated for re- currence of colorectal cancer, to achieve prolonged survival. Reprint requests to: M. Fuzun, Dokuz Eylul University Hospital, General Surgery, Inciralti, 35340 Izmir, Turkey Received: December 2, 2002 / Accepted: July 8, 2003 Abstract Purpose. Local recurrence after curative surgery for colorectal cancer may be treated by potentially curative surgery, defined as resection of all macroscopic disease. We conducted this retrospective study to show the ef- fectiveness of potentially curative resection for patients with locoregional recurrence (LRR). Methods. We reviewed the records of 242 patients who underwent curative resection of colorectal cancer in our unit between 1988 and 2000. Locoregional recurrence developed in 50 (20.6%) patients, and was treated by R 0 resection in 10 (20%) patients (group R 0 ), by R 1 resec- tion in 8 (16%) patients (group R 1 ), by R 2 resection in 13 (26%) patients (group R 2 ), and by surgery without resection in 12 (24%) patients (group NR). Seven (15%) patients did not undergo surgery (group NS). Results. The mean survival periods were 48, 36, 10, 5.6, and 5 months in groups R 0 , R 1 , R 2 , NR, and NS, respec- tively. There was no significant difference in survival between groups R 0 and R 1 (P = 0.5), but survival was significantly longer in groups R 0 and R 1 than in groups R 2 , NR, and NS (P = 0.001). Conclusion. These findings show that surgeons should aim to achieve at least macroscopic clearance of the recurrent tumor. Potentially curative surgery improves survival in selected patients with LRR after curative resection of colorectal cancer. Key words Colorectal cancer · Recurrence · Curative resection