title: Prognostic factors in ambulatory patients with inoperable locoregionally recurrent rectal cancer following curative surgery.
abstract: BACKGROUND
  The optimal treatment for locoregionally recurrent rectal cancer after curative surgery has not yet been defined. The definition of prognostic factors could lead to the selection of an aggressive therapeutic approach in patients with favourable prognosis alone.
  
  
  METHODS
  The records of thirty-nine ambulatory pts, 15 female and 24 male, with diagnosis of locoregionally recurrent rectal cancer (LRRC) after curative surgery and treated with radiotherapy were retrospectively analyzed. The following factors were analyzed for their ability to predict the clinical response and outcome for LRRC: age, sex, initial tumor grading, primary surgical approach, initial primary tumor stage according to Dukes' classification, disease free survival (time to primary surgery and detection of a LRRC), pelvic-perineal structure affected by recurrence, total radiation dose, chemotherapy with fluorouracil, symptomatic response to the therapy, locoregional symptomatic re-recurrence, systemic progression disease.
  
  
  RESULTS
  In the univariate analysis, predictive factors for survival, were graded (G1-2 vs G3 p = 0.04), Dukes' stage at first diagnosis (A-B vs C p = 0.01), and site of pelvic-perineal recurrence (Pelvic mass alone yes vs no p = 0.01; Nerve and/or Osseous involvement yes vs no p < 0.001). Following therapy for LRRC, a better survival was observed in pts with a complete symptomatic response (complete remission vs partial remission vs no change p < 0.001), without a further locoregional symptomatic re-recurrence (re-recurrence, yes vs no p = 0.001) and/or appearance of metastatic disease (yes vs no p < 0.001).
authors.affiliation: IST-Genova, Satellite Unit of Biomedical Technology (Radiobiomedical Area), c/o University of Messina, Italy. pergoste@solnet.it
authors.forename: S
authors.initials: S
authors.lastname: Pergolizzi
authors.forename: N
authors.initials: N
authors.lastname: Settineri
authors.forename: A
authors.initials: A
authors.lastname: Santacaterina
authors.forename: R
authors.initials: R
authors.lastname: Maisano
authors.forename: P
authors.initials: P
authors.lastname: Frosina
authors.forename: F
authors.initials: F
authors.lastname: Loria
authors.forename: G
authors.initials: G
authors.lastname: Nardella
authors.forename: G
authors.initials: G
authors.lastname: Garufi
authors.forename: G
authors.initials: G
authors.lastname: Sansotta
authors.forename: C
authors.initials: C
authors.lastname: De Renzis
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D009367:Neoplasm Staging; D011379:Prognosis; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D005472:Fluorouracil