title: The features of late local recurrences following curative surgery for rectal cancer.
abstract: OBJECTIVE
  Rectal cancers are characterized by high incidence of local recurrence after curative surgery, in some cases it occurs after 5 years. To determine the features of late locally recurrent rectal cancer (LRRC) is important for its management.
  
  
  METHODS
  The medical records of 110 patients with LRRC after curative surgery were reviewed. We examined the relationship between the interval between surgery and appearance of LRRC and various clinicopathological factors by dividing patients into the early (recurrence before 5 years after surgery) and late (recurrence after more than 5 years) recurrence groups.
  
  
  RESULTS
  In the late-recurrence group (n=7), well-differentiated adenocarcinoma was significantly higher (p=0.0031) and venous invasion was significantly lower (p=0.0105) than the early-recurrence group (n=113). Multivariate Cox regression analysis identified histological grade and venous invasion of primary lesion as independent predictors for early-onset LRRC (p=0.0396 and p=0.0009, respectively). The presence of symptoms at the time of diagnosis was the only factor that significantly related to resectability of LRRC (p=0.015).
  
  
  CONCLUSIONS
  For detection of asymptomatic LRRC, which can lead to curative resection, follow-up program after curative resection of rectal cancer should be designed based on the histological grade and venous invasion of primary tumor.
authors.affiliation: Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Uemura
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.forename: Shingo
authors.initials: S
authors.lastname: Noura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohue
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014680:Veins / Q000473:pathology