目的:本文主要分析原發直腸腺癌的經根除手術治療的結果以及討論復發直腸腺癌之拯救性治療扮演的角色。腺癌患者接受放射治療的登記資料，但手術過程中發現有骨盆腔以外擴散的的患者、確定診斷時接受姑息性手術者、及治療記錄不完整者皆不列入本文分析，有效分析者共有60位患者，所有病患均接受了根除手術，輔助治療採用放射線治療或化學治療則主要由外科醫師決定;腫瘤復發藉由理學檢查、影像檢查如電腦斷層或磁振造影、大腸鏡檢、癌胚抗原(CEA)、或是超音波檢查的結果來確定。本文使用Kaplan-Meier方法自手術日開始算起分析存活的時間。後到局部復發平均時間是26個月，術後到遠處轉移平均時間是21個月。僅有5位患者的單獨骨盆腔復發能夠接受再度治癒性的手術切除。直腸癌復發接受姑息性治療的患者，其中值存活時間是6個月，7位直腸癌復發的患者僅接受拯救性放射線治療，自診斷出腫瘤復發日算起，接受拯救性手術的患者之存活中值時間為16個月，對於僅接受拯救性放射治療的患者，其存活中值時間為8.5個月。患者可再次施行根除性的手術而獲得較長的存活時間。

　　　　　Purpose: This study was to analyze the treatment results of our patientswith rectal adenocarcinoma receiving curative surgery ± radiotherapy and discussthe role of salvage treatment for recurrence.received radiotherapy from 1980 to 1995 were registered at Department of RadiationOncology, Taichung Veteran General Hospital. The patients who were found to haveextrapelvic extension at operation, palliative surgery at diagnosis, and incompletedata were excluded. Sixty patients were analyzable. All these 60 patients receivedpotentially curative surgery at diagnosis. Adjuvant therapy with radiotherapy orchemotherapy was mainly decided by the surgeon. Recurrence of tumor was documentedby physical examination, imaging studies such as CT scan or MRI, colonoscopy, CEA,or sonography. The salvage treatment of recurrent tumor included re-operation withcurative or palliative intent, radiotherapy alone or with chemotherapy. Analysis ofsurvival was calculated from the date of operation using Kaplan-Meier method.33%, respectively. Overall recurrence rate was 88%. The mean loco-regional recurrencetime was 26 months vs. 21 months for distant metastasis. Only 5 patients with isoloatedpelvic recurrence can be salvaged by re-operation with curative intent. The patientswith recurrent cancer receiving palliative surgery survived at a median of 6 months.Seven patients with recurrent disease were salvaged with radiotherapy only. Thepatients with salvage surgery survived at a median of 16 months after diagnosis ofrecurrence vs. 8.5 months for patients with salvage radiotherapy only. Clinicalvariables such as age, gender, stage, tumor location, and tumor size had nostatistically significant impact on survival.Conclusion: There was substantially high recurrence rate for patients with evenpotentially curative resection of primary rectal adenocarcinoma. A minority ofpatients with isolated local recurrence can be salvaged by aggressive re-operationwith a relatively long survival.