Prognostic and predictive factors after surgical treatment for locally recurrent XXXX : a single institute experience.

@entity1 @entity478 @entity66 @entity5 @entity420
OBJECTIVE: Resection of locally recurrent @entity5 (LRRC) after curative resection represents a difficult problem and a surgical challenge. The aim of this study was to evaluate the results of resecting the local recurrence of @entity5 and to analyze factors that might predict curative resection and those that affect survival. @entity1 AND METHODS: A retrospective review was performed in 50 @entity1 who underwent surgical exploration with intent to cure LRRC between April 1998 and April 2005. All of the @entity1 had previously undergone resection of primary @entity420 . Of these @entity1 ' charts, operation and pathology reports were reviewed. @entity5 and treatment details, hospital of initial treatment and TNM stage were registered. The following data were collected concerning the detection of the local recurrence; date of recurrence, symptoms at the time of presentation and diagnostic work-up. Perioperative complication and date of discharge were also gathered. The recurrent @entity5 were classified as not fixed (F0), fixed at one site (F1) and fixed to two or more sites (F2) according to the preoperative and peroperative findings. Microscopic involvement of surgical margins and localization of recurrence were noted based on pathology reports. RESULTS: The median time interval between resection of @entity5 and surgery for locally recurrent disease was 24 (4-113) months. In a statistical analysis, initial surgery, complaints of @entity1 , increasing number of sites of the recurrent @entity5 fixation in the pelvis, location of the recurrent @entity5 were associated with curative surgery. Curative, negative resection margins were obtained in 24 (48%) of @entity1 ; in these @entity1 a median survival of 28 months was achieved, compared to 12 months (p=0.01) in @entity1 with either microscopic or gross @entity66 . Primary operation and @entity478 level at recurrence were also found to be important factors associated with improved survival. There was no operative mortality and, the complication rate was 24%. CONCLUSIONS: This study demonstrated that many @entity1 with LRRC can be resected with negative margins. The type of primary surgery, symptoms, location, and fixity of recurrent @entity5 are associated with the increased possibility of carrying out curative resection. Previous surgery and curative surgery are significant predictors of both disease-specific survival and overall survival.
