Type of recurrence is associated with disease-free survival after salvage surgery for locally recurrent rectal cancer

Rosa M. Jimenez-Rodriguez, Jonathan B. Yuval, Charles Etienne Gabriel Sauve, Isaac Wasserman, Piyush Aggarwal, Paul B. Romesser, Christopher H. Crane, Rona Yaeger, Andrea Cercek, Jose G. Guillem, Martin R. Weiser, Iris H. Wei, Maria Widmar, Garrett M. Nash, Emmanouil P. Pappou, Julio Garcia-Aguilar, Marc J. Gollub, Philip B. Paty*, J. Joshua Smith*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To compare the characteristics and outcomes of rectal cancer patients with local recurrence at a perianastomotic site (PA), a surgical field (SF) site, or in lateral lymph nodes (LLN). Methods: A total of 114 consecutive patients who underwent surgery for recurrent, non-metastatic rectal cancer at a single comprehensive cancer center between 1997 and 2012 were grouped on the basis of radiographic assessment of type of recurrence: PA, 76 (67%) patients; SF, 25 (22%) patients; LLN, 13 (11%) patients. Demographic, clinical, and pathological features were compared between the three groups, as were disease-free survival (DFS) and overall survival (OS). Results: Recurrence type was associated with positive circumferential margin in the primary resection (PA, 4 [6%]; SF, 4 [19%]; LLN, 3 [25%]; P = 0.027), prior neoadjuvant therapy for the primary tumor (PA, 57 [75%]; SF, 18 [72%]; LLN, 4 [31%]; P = 0.007), and location of the primary tumor in the upper rectum (PA, 33 [45%]; SF, 5 [23%]; LLN, 1 [8%]; P < 0.001). Patients with PA had longer median DFS (PA, 5.1 years; SF, 1.5 years; LLN, 1.2 years; P = 0.036). There was a non-significant trend toward longer OS and higher rates of R0 resection for PA. Conclusion: Type of recurrence after salvage surgery for locally recurrent rectal cancer is associated with longer DFS in patients with PA recurrence.

Original languageEnglish
Pages (from-to)2603-2611
Number of pages9
JournalInternational Journal of Colorectal Disease
Issue number12
StatePublished - Dec 2021
Externally publishedYes


FundersFunder number
National Institutes of Health
National Cancer InstituteP30 CA008748, T32CA009501
National Cancer Institute


    • Rectal cancer
    • Recurrence
    • Salvage surgery
    • Survival


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