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Local recurrence following rectal resection for cancer
1Department of Colorectal Surgery, Singapore General Hospital.
Journal of the Royal College of Surgeons of Edinburgh
|February 17, 1999
Summary
Local recurrence (LR) after rectal cancer surgery was low in this study. Current adjuvant therapies may not significantly reduce LR further in centers with already low rates, warranting re-evaluation.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Recurrent rectal carcinoma after surgery has a poor prognosis, with local recurrence (LR) rates varying widely.
- Current strategies for rectal cancer aim to minimize LR through pre-operative radiotherapy or adjuvant chemoradiotherapy.
Purpose of the Study:
- To evaluate the incidence of local recurrence (LR) in rectal cancer patients undergoing surgical resection.
- To assess the effectiveness of current treatment strategies in minimizing LR in a low-recurrence setting.
Main Methods:
- Retrospective analysis of 354 patients who underwent surgical resection for rectal cancer between April 1989 and March 1994.
- Categorization of patients by Dukes staging (A, B, C, D) and assessment of LR rates based on stage and curative resection status.
Main Results:
- Overall LR rate was 12.2% (43/354), with 9.4% (16/278) following curative resection.
- LR incidence increased with disease stage: Dukes A (0%), B (5.7%), C (14.6%), and D (22.3%).
- The study observed a low LR rate, suggesting pre-operative radiotherapy or adjuvant chemoradiotherapy might not significantly reduce LR further in this context.
Conclusions:
- Local recurrence following rectal cancer resection in this series was low.
- The role of pre-operative radiotherapy or adjuvant chemoradiotherapy needs re-evaluation for institutions achieving low local recurrence rates.