Locally recurrent rectal cancer (LRRC), which occurs in 6–12% of patients previously treated with surgery, with or without pre-operative chemoradiation therapy, represents a complex and heterogeneous disease profoundly affecting the patient’s quality of life (QoL) and long-term survival. Its management usually requires a multidisciplinary approach, to evaluate the several aspects of a LRRC, such as resectability or the best approach to reduce symptoms. Surgical treatment is more complex and usually needs high-volume centers to obtain a higher rate of radical (R0) resections and to reduce the rate of postoperative complications. Multiple factors related to the patient, to the primary tumor, and to the surgery for the primary tumor contribute to the development of local recurrence. Accurate pre-treatment staging of the recurrence is essential, and several classification systems are currently used for this purpose. Achieving an R0 resection through radical surgery remains the most critical factor for a favorable oncologic outcome, although both chemotherapy and radiotherapy play a significant role in facilitating this goal. If a R0 resection of a LRRC is not feasible, palliative treatment is mandatory to reduce the LRRC-related symptoms, especially pain, minimizing the effect of the recurrence on the QoL of the patients. The aim of this manuscript is to provide a comprehensive narrative review of the literature regarding the management of LRRC.
局部复发性直肠癌（LRRC）是指既往接受过手术治疗（无论是否联合术前放化疗）的患者中，约6%-12%出现的局部复发。该疾病具有复杂性和异质性，严重影响患者的生活质量及长期生存。其治疗通常需要多学科协作，以全面评估LRRC的多个方面，如可切除性或最佳症状缓解方案。手术治疗更为复杂，通常需要在高手术量的医疗中心进行，以提高根治性（R0）切除率并降低术后并发症发生率。局部复发的发生与患者因素、原发肿瘤特征及原发肿瘤手术情况等多种因素相关。对复发灶进行精确的预处理分期至关重要，目前已有多种分类系统应用于此。尽管化疗和放疗在实现根治目标中发挥重要作用，但通过根治性手术达到R0切除仍是获得良好肿瘤学结局的最关键因素。若无法实现LRRC的R0切除，则必须进行姑息治疗以缓解相关症状（尤其是疼痛），从而最大限度降低复发对患者生活质量的影响。本文旨在对LRRC的治疗策略进行全面的文献综述。
肿瘤(癌症)患者之家