A Case of Postoperative Intrapelvic Locally Recurrent Rectal Cancer in which Long-term Complete Response was Achieved after Chemoradiotherapy

Abstract

We report a case of intrapelvic locally recurrent rectal cancer after surgery in which clinical complete response was achieved after chemoradiotherapy with capecitabine and oxaliplatin (CAPOX), and discuss the relevant literature. The patient was a 67-year-old woman who had undergone lower anterior resection for Ra rectal cancer. Nine months after the surgery, contrast-enhanced CT scans of the abdomen and pelvis, which were taken because of perineal pain, revealed a 48-mm mass in the pelvic floor, and the patient was thus diagnosed as having local recurrence. Since the lesion was suspected to have invaded surrounding organs, radical resection was considered impractical, and chemoradiotherapy was chosen. Radiation (50 Gy) + eight courses of CAPOX were administered. A contrast-enhanced CT examination of the abdomen 5 months after starting chemoradiotherapy revealed a marked size reduction of the recurrent lesion, which was identified as a 23-mm soft tissue shadow, with no signs of distant metastasis. As of 9 years and 6 months after the diagnosis of intrapelvic local recurrence and 8 years after the completion of chemoradiotherapy, metastatic recurrence has not been reported.