Outcomes of resection for locoregionally recurrent colon cancer: A systematic review.

Background: The value of resection for locoregionally recurrent colon cancer (LRCC) is controversial. We aimed to describe the outcomes of resection for LRCC.

Methods: A systematic search in MEDLINE, EMBASE, and Cochrane CENTRAL identified 9 retrospective, uncontrolled cohort studies reporting overall survival following resection of LRCC in 550 patients. Outcomes were pooled using random effects models.

Results: Postoperative morbidity was frequent (41.5%), but 30-day mortality was low (2.1%). R0 resection was achieved in 191 (50.6%) patients with a pooled rerecurrence of 25% and was associated with 3-year overall survival of 58% (95% confidence interval: 39-76) and 5-year overall survival of 52% (32-72). By contrast, R1 resection (n = 60) was associated with inferior survival: 3-year overall survival of 27% (12-41) and 5-year overall survival of 11% (2-25). Following macroscopically incomplete resection (R2, n = 86), 3-year overall survival was 11% (5-7) with no 5-year survivors.

Conclusion: The available literature suggests that resection can be performed safely, with long-term survival expected in about one half of patients who undergo microscopically complete resection. However, it cannot be ascertained whether these favorable outcomes are the result of patient selection or if they can be attributed to resection. Creating a prospective registry of all patients with LRCC would be a step toward addressing the lack of quality evidence for this intervention.