[Factors in recurrence after curative resection of rectal cancer]

Data on 409 Patients who had a curative resection for rectal cancer at the National Taiwan University Hospital between 1977 and 1989 were analysed to determine the independent effect on recurrence. In our series, the total operative mortality rate was 1.7% and the resectability rate was 88.1%. For these cases who received curative resection, the overall 5-year survival rate was 62.6%. The 5-year survival rate varied according to the Dukes' stage: stage A, 96.4%; stage B, 73.3% and stage C, 39.6%. The total recurrence rate after curative resection was 35.9%, including local recurrence 18.3%, systemic recurrence 12.0%, and combined recurrence 5.6%. According to Dukes' staging system, the recurrence rate for stage A, B and C were 0%, 22.4% and 63.8%, respectively. We used Cox's regression model to analyse the patients characteristics and pathological variables on recurrence and to assess the independent influence of each when all other factors were held constant. The pathological stage of the cancer had the strongest association. Other variables found to have an independent yet significant importance, were CEA level and tumor size. The identification of the patient group, at a high risk of recurrence, might promote a more judicious selection for surgical procedure and trials of adjuvant therapy.