[Rectal cancer: prognostically relevant factors for the development of local recurrence following radical anterior resection].
The study was designed to detect criteria which influence the incidence of local recurrence after radical anterior resection for rectal cancer. Local recurrence developed in 18 patients (20%) out of 90. All patients entered a prospective clinical study for the detection of local recurrence (mean observation time: 50 months). The following criteria were evaluated retrospectively: age, sex, staging, grading, gross appearance of the tumour, lymphatic reaction, invasion of lymph and blood vessels, perineural invasion, mucus production of the tumour and width of the distal margin of clearance (measurement in cm in the specimen immediately after resection). Kaplan-Meier survival functions estimated the probability of staying free of local recurrence depending on the various criteria. Statistical significance was calculated using the tests of Breslow and Mantel. The incidence of local recurrence (%) depended on Dukes stage (A: 7%, B: 17%, C: 40%; p less than or equal to 0.03), grading (well differentiated: 5%, average: 20%, poorly differentiated: 55%; p less than or equal to 0.02), gross appearance (protuberant: 15%, infiltrating: 47%; p less than or equal to 0.006), lymphatic stroma reaction (yes: 10%, no: 45%; p less than or equal to 0.006), invasion of veins (yes: 75%, no: 20%; p less than or equal to 0.002), perineural invasion (yes: 52%, no: 17%; p less than or equal to 0.001) and the margin of clearance (less than 1 cm: 52%, 1-3 cm: 10%, greater than 3 cm: 15%; p less than or equal to 0.02 Mantel, p less than or equal to 0.05 Breslow between less than 1 cm vs. 1-3 cm and greater than 3 cm, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
Feil
W
W
I. Chirurgische Universitätsklinik, Wien.
Wunderlich
M
M
Kovats
E
E
Neuhold
N
N
Schemper
M
M
Schiessel
R
R
D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*
Rektumkarzinom: Prognostisch relevante Faktoren für die Entstehung von Lokalrezidiven nach radikaler vorderer Resektion.