Local recurrence after laparoscopic resection of T3 rectal cancer without preoperative chemoradiation and a risk group analysis: an Asian collaborative study.
Risk factors for local recurrence and indication for preoperative radiation therapy have not been well evaluated for patients undergoing laparoscopic rectal cancer operation. From 1998 to 2004, 497 T3 rectal cancer patients with tumor located within 12 cm from the anal verge who had undergone laparoscopic surgery without preoperative radiation therapy by eight experienced laparoscopic surgeons in four Asian countries were reviewed retrospectively for the incidence of local recurrence and related factors. The median follow-up was 29.0 months (range, 6.0 to 92.3), and 31 cases of local recurrence were observed during the follow-up period (6 anastomosis site, 6 perineum, 17 pelvic wall, and 2 unclassified). The estimated local recurrence rates at 24 and 60 months were 5.42 and 9.41%, respectively. Patient's gender, tumor location, lymph node metastasis, and tumor perforation were independent factors for local recurrence by multivariate analysis. The local recurrence rate was comparable to previous studies using conventional open surgery with preoperative chemoradiation, except for a subgroup of male patients with the tumor located within 7 cm from the anal verge. The indication for preoperative radiation therapy would be different from those who will undergo conventional open surgery, and further evaluation of the benefits of preoperative radiation therapy is required for those with low risk tumor.
Lee
Sun-Il
SI
Department of Surgery, Korea University Anam Hospital, #126-1, 5-ga, Anam-dong, Sungbuk-gu, Seoul 136-705, South Korea.
Kim
Seon-Hahn
SH
Wang
Hwei-Ming
HM
Choi
Gyu-Seog
GS
Zheng
Min-Hua
MH
Fukunaga
Masaki
M
Kim
Jun-Gi
JG
Law
Wai Lun
WL
Chen
Joe-Bin
JB
D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors