Abstract
Intraabdominal recurrence of colorectal cancer is associated with a dismal prognosis. We hypothesized that reoperation with resection of recurrent disease may augment survival. Eighteen patients with postoperative peritoneal recurrence were studied. Eleven patients comprised the nonoperative “conservative group” while 7patients, the “operative group”, were treated with resection of macroscopic recurrent disease followed by the intraperitoneal injection of MMC. Four of these 7 had demonstrated only a positive CEA analysis and none had abnormal imaging studies. The follow-up outcomes for the operative group versus the conservative group included a prolonged symptom-free interval (33mo vs 16.2mo) and an enhanced 50% survival rate (32mo vs 5mo). These data suggest that in patients who are CEA positive but imaging negative, after initial resection of colorectal cancer, that exploratory laparotomy should be done to identify and resect intraabdominal recurrent disease as early as possible
