title: [Evaluation of risk factors associated with local recurrence after radical resection of rectal carcinoma].
abstract: OBJECTIVE
  To investigate the risk factors of local recurrence after radical resection of rectal carcinoma.
  
  
  METHODS
  Clinical and follow-up data of 535 patients with rectal carcinoma, received radical resection between August 1994 and July 2004 in our department, were reviewed retrospectively. The association of clinicopathological factors and local recurrence was analyzed using Log-rank test. Cox multiple variate analysis was conducted to determine the independent risk factors.
  
  
  RESULTS
  All the 535 rectal carcinoma patients underwent radical resections. Local recurrence occurred in 53 cases (9.9%), and distant metastasis co-occurred in 39 cases (7.3%). The time from the first operation to the recurrence was 4-54 months with a median of 12 months. The Log-rank test showed that the primary tumor site (P<0.01), differentiation(P<0.01), histological type(P=0.038), lymph node metastasis(P=0.023), Dukes staging(P=0.045), blood transfusion(P=0.001), and total mesorectum excision (TME)(P<0.001) were associated with the recurrence, but the operative style(P=0.908), invasive depth of primary tumor(P=0.735), massive pathological type(P=0.562), degree of surgeon(P=0.171) and post-operative chemotherapy (P=0.772) were not associated with the recurrence. Cox multiple variate analysis revealed that blood transfusion, primary tumor site, differentiation, lymph node metastasis, and TME principle were independent prognostic factors affecting local recurrence after radical resection of rectal cancer.
  
  
  CONCLUSIONS
  Blood transfusion, low position of tumor, poor differentiation, lymph node metastasis are the risk factors associated with local recurrence in rectal cancer. Application of TME principle is the key point to decrease the local recurrence rate.
authors.affiliation: Department of Colorectal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Cui
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Wang
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Huang
authors.forename: Jun
authors.initials: J
authors.lastname: Xiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008643:Mesentery / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D011184:Postoperative Period; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult