[Analysis of factors related to recurrence after local excision for low rectal cancer].
OBJECTIVE
To discuss the factors predicting recurrence after local excision for low rectal cancer.


METHODS
Medical records and follow-up histories of 97 patients undergone local excision of adenocarcinoma of the rectum between April, 1975 and April, 2005 in Cancer Hospital of the Chinese Academy of Medical Sciences were reviewed retrospectively.


RESULTS
Postoperative pathologic examination revealed 28 pTis cases, 48 pT(1) cases, and 21 pT(2) cases. Eighty-nine patients underwent transanal excision, 7 transsacral excision, and 1 transvaginal excision. Twenty-two(45.8%) patients with T(1) tumors and 14(66.7%) patients with T(2) tumors were treated with postoperative radiotherapy with or without 5-fluorouracil. Seventeen(17.5%) patients presented recurrence, including 13 local recurrence, 2 local and distant recurrence, and 2 distant recurrence. The local recurrence rate was 15.5%. Median time to relapse was 27 months(range 4-73). The incidence of local recurrence were 7.1%, 12.5%, and 33.3% for patients with pTis, pT(1), and pT(2)(P=0.031) respectively. The local recurrence rate was 10.5%, 13.7%, and 3/5 for patients with pedunculated, sessile, and ulcerative carcinoma(P=0.017). The local recurrence of patients with T(2) tumors treated via local excision with or without chemoradiotherapy was 21.4%(3/14) and 4/7, but the difference was no significance(P=0.127). All the 15 patients with local recurrence underwent salvage resection, and the 5-year survival rate after salvage surgery was 59.6%.


CONCLUSIONS
Higher rates of recurrence are seen in patients with T(2) tumors and ulcerative carcinoma. Chemoradiotherapy or radical surgery should be chosen for T(2) tumors following local excision. Salvage resection should be considered after local recurrence.
Liang
Jian-Wei
JW
Department of Abdominal Surgical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Wang
Zhen
Z
Zhou
Zhi-Xiang
ZX
Bi
Jian-Jun
JJ
Liu
Qian
Q
Zhao
Ping
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies