Prognostic factors affecting local recurrence and survival for operable rectal cancers

The aim of this study was to define the local recurrence, survival rates and independent prognostic factors for survival, and local recurrence in patients with rectal carcinoma treated throughout 7 years. Between January 1990 and January 1998, 197 consecutive patients with rectal carcinoma, who underwent resection by conventional technique in Ankara Oncology Hospital, were retrospectively reviewed. Several clinical and pathological characteristics of patients were categorized. Kaplan-Meier method was used to obtain survival curves, and independent prognostic factors affecting survival and local recurrence were obtained by Cox regression analysis. 5-year survival, and local recurrence rates were 59%, and 33%, respectively. Stage, location of the tumour in distal one third, anterior resection, and poor differentiation were found to be independent detrimental influence on local recurrence. The independent prognostic factors for survival were invasion of tumour into serosa and adjacent organs, lymph node metastases and the total number of resected lymph nodes. Adjuvant therapy affected favourably local recurrence in stage II and III patients, and survival in stage III patients. In conclusion our local recurrence is high in stage I patients as well as in stage II and III patients although most of the patients received adjuvant therapy. Conventional technique might be responsible for high local recurrence rates; therefore, total mesorectal excision technique may be the proper choice to achieve a local recurrence rate under 10% and to have a better survival.