LAUSR

C Local recurrence (LR) received less attention but potentially suffered from more controversies in colon cancer than in rectal cancer. Apart from the impact of surgery, the LR rate of colon cancer was also affected by other factors such as severity of disease or adjuvant treatment. More than 10% of colon cancer patients experienced LR in previous studies, which was different from Dr Trilling’s cited study. This is probably due to the different definitions of LR. As mentioned in the literature cited by Dr. Trilling, ‘‘The typical sites of LR are divided into 4 groups: the anastomotic site, mesentery or nodal basin, retroperitoneum, and peritoneum. Peritoneal carcinomatosis is a rare pattern of recurrence after potentially curative resection, accounting for 3% to 6% of LR.’’ The LR rate mentioned in this article did not include all types of LR, and only analyzed patients with metastatic peritoneal implants. In our opinion, multiple peritoneal tumor lesions in the abdominal cavity should be considered as metastases because these metastatic lesions may not necessarily be related to the surgery. Even if these lesions are not found in the initial operation, it does not rule out the presence of tiny peritoneal lesions before surgery. In our study, LR was defined as any recurrence in the surgical field. As mentioned in our previous response letter, we established that 9.0% of patients in the noncomplete mesocolic excision (NCME) 4.