Diagnosis and management of local and locoregional recurrence of colorectal carcinoma.

All intraabdominal forms of recurrence of colorectal carcinoma, other than metastases in the liver, are considered a locoregional treatment failure. Maximum frequency of local recurrence of CRC occurs in the first two years following the initial potentially curative resection. Intensive follow-up in this period is therefore reasonable. It should be based on case history, clinical examination and examination of tumor markers (particularly CEA). Other examinations are indicated only for patients with abnormal findings or during normal annual check-ups. The salvage surgery for CRC recurrence covers a large scale of surgical performances from limited local resections up to extensive surgery including pelvic exenteration and peritonectomy. The potentially curative resection (R0 and R1) of colorectal carcinoma is a sole confirmed factor that has a direct positive influence on the overall survival of patients (Fig. 5, Ref. 21).