title: Rate and treatment of pelvic recurrence after abdominoperineal resection and low anterior resection for rectal cancer.
abstract: OBJECTIVE
  This study was designed to analyze factors of importance for local recurrence after radical surgery for rectal cancer and to analyze course and outcome of treatment of pelvic recurrence.
  
  
  METHODS
  One hundred seventy-five patients treated for rectal cancer with low anterior resection (LAR) or abdominoperineal resection (APR) were studied, retrospectively. Seventy-four patients had LAR and 101 had APR.
  
  
  RESULTS
  The two groups were comparable with respect to Dukes classification, histologic differentiation, and male to female ratio. The rate of pelvic recurrence was 18 percent for LAR and 24 percent for APR (not significant). Recurrence rates were 27 percent after stapled anastomoses and 10 percent after handsewn anastomoses respectively (P = 0.09). Twenty five had pelvic recurrence diagnosed without signs of distant metastatic disease. They were treated with radiotherapy, palliative operations, or analgesics. The group receiving radiotherapy had a significantly longer survival (15.9 months) compared with other groups (2.4 months; P < 0.001).
  
  
  CONCLUSIONS
  There is no difference in local recurrence rate after LAR and APR. Radiotherapy seems to increase survival in patients with an unresectable recurrence and should be offered irrespective of pain.
authors.affiliation: Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Nymann
authors.forename: P
authors.initials: P
authors.lastname: Jess
authors.forename: J
authors.initials: J
authors.lastname: Christiansen
mesh_terms: D000005:Abdomen / Q000601:surgery; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D010166:Palliative Care; D010386:Pelvic Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000628:therapy*; D010502:Perineum / Q000601:surgery; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling; D015996:Survival Rate; D013536:Suture Techniques; D016896:Treatment Outcome