There are various definitions for salvage surgery in head and neck cancer. To my knowledge there are no currently international or even nationally agreed definitions as to what constitutes a completion operation and a salvage procedure for recurrent rectal cancer following previous local excision.
We use term “completion surgery” only for those cases requiring surgery because of positive margin after previous local excision/TEM. “Salvage surgery” is term used for interventions performed to treat recurrences diagnosed during follow up. In both cases proctectomy with TME is the procedure of choice. Sphincter preservation is almost always possible.
I agree with A Julianov that we use the term of " completion surgery" only for those cases requiring surgery In case of unfavourable histology after TEM, or positive resection margins . Conversely, The "salvage surgery" is used for a surgical procedure performed for recurrence after a full-thickness transanal excision for Stage I rectal cancer. In both cases a TME- proctectomy is the surgical procedure of choice and the sphincter preservation is mostly possible. But in both cases, the results aren't equivalent .
In fact , if no difference was found in outcome between patients with rectal cancer undergoing TME-proctectomy after TEM and those undergoing primary TME , in case of Salvage surgery for recurrence after local excision of rectal cancers it may not provide results equivalent to those of initial radical treatment.
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The outcome of rectal cancer after early salvage TME following TEM compared with primary TME: a case-matched study.
Levic K1, Bulut O, Hesselfeldt P, Bülow S.
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Early rectal cancer: local excision or radical surgery?
Chang AJ1, Nahas CS, Et al.
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Salvage radical surgery after failed local excision for early rectal cancer.
Friel CM1, Cromwell JW, Marra C, Madoff RD, Rothenberger DA, Garcia-Aguílar J.
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