title: Local recurrence after curative resection for colorectal cancer: frequency, risk factors and treatment.
abstract: Analysis of 498 patients with colorectal carcinoma was retrospectively reviewed to evaluate the incidence, risk factors and therapy of local recurrent carcinoma following curative resection. Complete follow-up information was obtained in all but four patients (99.2%). After a median follow up of 42 months, 64 out of 469 (13.6%) patients developed local recurrence (LR). The incidence of LR was higher in rectal than in colon cancer patients (18.3% vs 8.9%) (P less than 0.005). Separate univariate and Cox analyses for rectal patients showed tumor site (P less than 0.02). Dukes stage (P less than 0.002), and adjuvant radiotherapy (P = 0.05) determined risk of LR. For colon cancer patients risk of LR was determined by histological tumor grade (P less than 0.01). Out of 64 patients, 5 (7.8%) underwent radical excision of LR. Forty percent of these survived at 5-year (P less than 0.08). Palliative treatment (radio-chemotherapy) obtained a 5-year survival of 15.3%, with no survivors in no-treatment group. These results suggest that local recurrent colorectal carcinoma remain a difficult treatment problem. More effective combinations of surgery and adjuvant therapy are therefore mandatory to reduce the incidence of local failure in high risk colorectal patients.
authors.affiliation: First Department of Surgery, University of Rome, La Sapienza, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Stipa
authors.forename: V
authors.initials: V
authors.lastname: Nicolanti
authors.forename: C
authors.initials: C
authors.lastname: Botti
authors.forename: M
authors.initials: M
authors.lastname: Cosimelli
authors.forename: E
authors.initials: E
authors.lastname: Mannella
authors.forename: F
authors.initials: F
authors.lastname: Stipa
authors.forename: D
authors.initials: D
authors.lastname: Giannarelli
authors.forename: C
authors.initials: C
authors.lastname: Bangrazi
authors.forename: R
authors.initials: R
authors.lastname: Cavaliere
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors