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Survival Outcomes after Total Mesorectal Excision for Rectal Cancer - A Single Institution Experience
Suresh Kumar1, S Navin Noushad1, Ajay Sharma1
1Tamil Nadu Government Multi Super Specality Hospital, Chennai, Tamilnadu India.
Indian Journal of Surgical Oncology
|April 27, 2026
Summary
Multimodality treatment for rectal cancer significantly improves survival and reduces recurrence. Key factors predicting poorer outcomes include younger age, elevated CEA levels, higher tumor grade, and incomplete adjuvant chemotherapy.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Multimodality treatments have advanced rectal cancer prognosis over four decades.
- 5-year tumor survival increased from 60% to 79%; local recurrence dropped from 14.3% to 5.3%.
Purpose of the Study:
- Evaluate oncological outcomes of total mesorectal excision (TME) in South Indian rectal adenocarcinoma patients.
- Assess local recurrence, survival rates, and factors influencing survival post-TME.
Main Methods:
- Retrospective analysis of 190 rectal adenocarcinoma patients undergoing TME (2015-2024).
- Kaplan-Meier method for disease-free and overall survival assessment.
- Univariate analysis (log rank test) to identify high-risk factors.
Main Results:
- Median follow-up: 55 months.
- Local recurrence: 2.7%; distant recurrence: 12%.
- Overall survival: 89.4% (Stage I: 100%, Stage II: 94%, Stage III: 73.8%).
- Disease-free survival: 87.7%.
Conclusions:
- Multimodality treatment achieves low local recurrence and favorable overall survival for rectal cancer.
- Poorer survival associated with age <50, baseline CEA >4 ng/mL, higher tumor grade, and incomplete adjuvant chemotherapy.
