J.Jpn. Surg. Soc.. 100(2): 206-210, 1999

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Feature topic

TREATMENT OF POST OPERATIVE RECURRENCE OF COLORECTAL CANCER

The survival rate of patients with colorectal cancer is fairly good after curative surgery. Approximately 80 and 75％ of patients suffering from colorectal cancer survive for 5 years after curative operation, respectively. However, 30％ of patients experience recurrence (mainly liver, lung, and local lesions) postoperatively. Resection of the recurrence is carried out in an attempt to achieve prolonged survival, Thirty percent to 40％ of patients survive after curative surgery for liver metastases and 35％ to 45％ after that for lung metastases. Total pelvic exenteration is performed in patients with local recurrence of rectal cancer and 30％ to 40％ survive for 5 years. However, for patients with unresectable recurrence, chemotherapy and radiation contribute to a better quality of life and prolonged survival. A 70％ response rate is achieved in patients with liver metastases after continuous infusion chemotherapy into the hepatic artery. Currently, the most important factor in achieving prolonged survival after colorectal surgery is to follow patients carefully in order to detect recurrence as early as possible. In the treatment of recurrence, the possibility of curative surgery, a combined treatment strategy, and the quality of life of patients must be considered.

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