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. 2025 Jun;131(8):1637-1641.
doi: 10.1002/jso.28120. Epub 2025 Mar 28.

Early Detection of Local Recurrence After Rectal Cancer Resection in Asymptomatic Patients Is Essential for Survival

Katharina Esswein  1 , Eva Hummer  1 , Marijana Ninkovic  1 , Elisabeth Gasser  1 , Veronika Kröpfl  1 , Reinhold Kafka-Ritsch  1
Affiliations

Early Detection of Local Recurrence After Rectal Cancer Resection in Asymptomatic Patients Is Essential for Survival

Katharina Esswein et al. J Surg Oncol. 2025 Jun.

Abstract

Background and objectives: Despite advancements in rectal cancer treatment, therapy of local recurrence remains a significant challenge as it has to be individualized to the extent of recurrence and prior treatment. This study aims to analyze outcomes of patients with local recurrence after resection for rectal cancer, focusing on R0-resection rates and overall survival (OS).

Methods: A retrospective cohort study included 31 patients with local recurrence after initial curative resection for rectal cancer between 2003 and 2021.

Results: Recurrence was diagnosed in 77.4% of cases during scheduled routine follow-up and 58,1% of patients reported of symptoms at the time of diagnosis. Symptomatic patients tended to be treated palliatively (66.7%, 12/18, p = 0.073). A curative treatment approach was intended in 48.4% of all patients, with 80% achieving R0-resection by surgery. The 5-year OS was significantly longer in patients achieving R0-resection (58.3% vs. 5.3%, p = 0.0) and decreased in symptomatic patients (11.1% vs. 46.2%, p = 0.025).

Conclusions: These findings emphasize the importance of early recurrence detection, optimally in a scheduled cancer follow-up.

Keywords: R0 resection; prognosis; rectal neoplasm; survival; treatment outcomes.

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