Review the risk factors for local recurrence of rectal cancer. Describe clinical and radiological features of local recurrence of rectal cancer. Review the imaging patterns of early recurrence and the limitations or difficulties when reading these studies.

Around 14000 new cases of rectal cancer are diagnosed in Spain every year (gross incidence rate of 30) with a net survival of around 68% and 62% for men and women, respectively, similar to the rest of European countries. Unfortunately, and despite all efforts, around 4,000 patients die from rectal cancer every year, mostly attributable to locoregional recurrence after curative surgery. When a patient with rectal cancer is diagnosed there is a probability of 80% that curable surgery can be performed, that is including cases...

SITES OF LOCAL RECURRENCE There are several classification systems based on anatomical compartments to systematically describe the site of recurrence of rectal tumors: Presacral: adjacent to the sacral bone (most common). Anterior: it can affect the bladder, uterus, vagina, seminal vesicles or the prostate gland. Anastomotic: at the staple line (best prognosis). Lateral: affecting the pelvic sidewall in the obturator lymph node compartment or along the iliac vessels (worst prognosis). Perineal: involving the perineum, anal sphincter complex or ischioanal/ischiorectal spaces. [Fig 18] DIFFERENT TREATMENT: DIFFERENT...

Many patients who have undergone primary curative treatment for rectal cancer will develop local recurrence and its early detection is crucial to improve their survival. There are several risk factors for local recurrence and different patterns of local recurrence based on anatomy of the pelvis. CT is recommended as the modality of choice in follow-up protocols for patients who have undergone curative treatment and radiologists must be aware of all the factors involving rectal tumor recurrence and the appearance of the disease in imaging studies.

E. Gonzalez-Cardenas: Nothing to disclose M. Barxias Martín: Nothing to disclose A. Núñez Martín: Nothing to disclose M. De Iruarrizaga Gana: Nothing to disclose J. Fernández García: Nothing to disclose

​Sociedad Española deOncologíaMédica.CifrasdelCáncerenEspaña. SEOM. 2021; JörgrenF, Johansson R, Damber L, Lindmark G. Risk factors of rectal cancer local recurrence: population-based survey and validation of the Swedish rectal cancer registry. Colorectaldisease :the official journal of the Association of Coloproctology of Great Britain and Ireland. 2010;12(10):977–86. Enríquez-NavascuésJM, Borda N,LizerazuA, Placer C,EloseguiJL, Ciria JP, et al. Patterns of local recurrence in rectal cancer after a multidisciplinary approach. World Journal of Gastroenterology. 2011;17(13):1674–84. denDulkM,MarijnenCAM, Putter H, Rutten HJT, Beets GL, Wiggers T, et al. Risk Factors for Adverse Outcome...