Local recurrence of rectal cancer in a national two-year cohort

Abstract Introduction As the management of patients with local recurrence of rectal cancer has evolved over time, the aim of this study was to describe diagnosis, treatment and outcome of local recurrence in a recent national unselected two-year cohort. Method All patients registered with a diagnosis of rectal cancer in 2016 and 2017 who underwent abdominal resection of the rectal tumour were identified in the SCRCR. Medical charts were reviewed, identifying all patients diagnosed with local recurrence until end of follow-up June 30th, 2022. Result Of a total of 2828 included patients, 166 (5.9%) were diagnosed with local recurrence during the follow-up period. The median time to diagnosis of local recurrence was 19 months (range 1-69). Ninety-seven patients (58%) were diagnosed at scheduled follow-up. The most common anatomical site of local recurrence was the anastomosis/rectal stump (25%), followed by lateral recurrence (19%). Concurrent metastatic disease was seen in 90 patients (54%). Fifty-nine patients (36%) were considered for curative treatment. The tumour recurrence was resected in 54 patients (33%), which included pelvic exenteration surgery in 17 cases (31%). Microscopical radicality was achieved in 38 of resected patients (70%). At end of follow-up, only 29 patients (18%) were considered tumour free. Discussion The prognosis for patients with local recurrence is still poor. Considering that a large proportion of patients were diagnosed outside of scheduled follow-up, this may be insufficient to detect local recurrence. Whether more patients would be cured if diagnosed earlier is, however, unknown.