This book analyzes all aspects of modern multimodal treatment of locally
recurrent rectal cancer in the pelvis in order to offer a panoramic
overview of the different therapeutic options and enable the reader to
balance their benefits and drawbacks. Indications for surgery and the
surgical techniques themselves, including reconstruction techniques
after major exenterative surgery, are clearly described and evaluated.
The role of new imaging tools, such as MRI and PET-CT, in staging
recurrences and guiding therapy is assessed and detailed consideration
is given to the use of neoadjuvant and iterative radiotherapy and the
indications for systemic chemotherapy. Morbidity, mortality, oncologic
outcomes, and quality of life issues are carefully analyzed and options
for pain control and palliation are examined. Finally, a national survey
is presented on the state of the art in the surgical treatment of
locally recurrent rectal cancer in Italy. While there has been a
dramatic fall in the incidence of local pelvic recurrences, their
treatment remains a major clinical challenge which requires a
multidisciplinary approach and careful selection of the most appropriate
strategy in each case. This book will aid practitioners in making the
correct decisions in individual patients.