Long-term outcomes following resection of retroperitoneal recurrence of colorectal cancer

BackgroundThe role of curative-intent surgery for retroperitoneal recurrence (RPR) of colorectal cancer (CRC) remains controversial. We previously showed 0% mortality and acceptable morbidity in patients who underwent resection of RPR.1 Here we examine long-term overall and disease-free survival (OS, DFS).MethodsWe identified patients who underwent resection for RPR of CRC between 01/1999 and 02/2010 from two prospective CRC databases.ResultsThe study cohort was composed of 48 patients (26 women) whose median age was 60 (36–80) years. Eleven patients had previously undergone resection of a different focus of disease recurrence, and 8 patients had additional site(s) of distant metastatic disease at the time of RPR resection. Following surgery for RPR, 5 patients were left with gross residual disease, and 6 had microscopically positive margins. Median follow-up was 32 (3–127) months. At last follow-up, 13 patients had died of cancer and 1 of other causes. For the entire cohort of 48 patients, 5-year OS was 70% (median 80mo). In univariate analysis, OS was reduced in younger patients (p = 0.003) and in those with gross residual disease (p = 0.033). In patients who had grossly complete resection, 5-year DFS was 49% (median 38mo). Predictors of reduced DFS on multivariable analysis were young age and R1 resection.ConclusionOS and DFS after resection of RPR in well-selected patients were favorable. Patients with RPR of CRC should be considered for curative-intent surgery with careful discussion at multidisciplinary cancer conference.