The features of late local recurrences following curative surgery for rectal cancer

Rectal cancers are characterized by high incidence of local recurrence after curative surgery, in some cases it occurs after 5 years. To determine the features of late locally recurrent rectal cancer (LRRC) is important for its management.

The medical records of 110 patients with LRRC after curative surgery were reviewed. We examined the relationship between the interval between surgery and appearance of LRRC and various clinicopathological factors by dividing patients into the early (recurrence before 5 years after surgery) and late (recurrence after more than 5 years) recurrence groups.

In the late-recurrence group (n=7), well-differentiated adenocarcinoma was significantly higher (p=0.0031) and venous invasion was significantly lower (p=0.0105) than the early-recurrence group (n=113). Multivariate Cox regression analysis identified histological grade and venous invasion of primary lesion as independent predictors for early-onset LRRC (p=0.0396 and p=0.0009, respectively). The presence of symptoms at the time of diagnosis was the only factor that significantly related to resectability of LRRC (p=0.015).

For detection of asymptomatic LRRC, which can lead to curative resection, follow-up program after curative resection of rectal cancer should be designed based on the histological grade and venous invasion of primary tumor.