title: Recurrence risk and prognostic parameters in stage I rectal cancers.
abstract: BACKGROUND
  The standard therapy for stage I rectum cancer is surgical resection. Currently, there is no strong evidence to suggest that any type of adjuvant therapy is beneficial. The risks of local relapse and distant metastasis are higher in rectal tumors. Therefore, while there is no clearly defined absolute indication for adjuvant therapy in lymph node negative colon cancers, rectum tumors that are T3N0 and higher require adjuvant treatment. Due to the more aggressive nature of rectal cancers, we explored the clinical and pathologic factors that could predict the risk of relapse in Stage I (T1-T2) disease and whether there was any progression-free survival benefit to adjuvant therapy.
  
  
  METHODS
  This multicenter study was carried out by the Anatolian Society of Medical Oncology. A total of 178 patients with rectal cancers who underwent curative surgery between January 1994 and August 2012 in 13 centers were included in the study. Patient demographics, including survival data and tumor characteristics were obtained from medical charts.
  
  
  RESULTS
  The median age was 58 years (range 26-85 years). Most tumors were well or moderately differentiated. For adjuvant treatment, 13 patients (7.3%) received radiotherapy alone, 12 patients (6.7%) received chemotherapy alone and 15 patients (8.4%) were given chemoradiotherapy. Median follow up was 29 months (3-225 months). Some 42 patients (23.6%) had relapse during follow up; 30 with local recurrence (71.4%) whereas 12 (28.6%) were distant metastases. Among the patients, 5-year DFS was 64% and OS was 82%. Mucinous histology and receiving adjuvant therapy were found to have statistically insignificant correlations with relapse and survival.
  
  
  CONCLUSIONS
  In our retrospective analysis, approximately one quarter of patients exhibited either local or systemic relapse. The rates of relapse were slightly higher in the patients who had no adjuvant therapy. There may thus be a role for adjuvant therapy in high-risk stage I rectal tumors.
authors.affiliation: Department of Medical Oncology, Okmeydani Education and Research Hospital, Istanbul, Turkey E-mail : masendur@yahoo.com.tr.
authors.forename: Sener
authors.initials: S
authors.lastname: Cihan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kucukoner
authors.forename: Nuriye
authors.initials: N
authors.lastname: Ozdemir
authors.forename: Faysal
authors.initials: F
authors.lastname: Dane
authors.forename: Mehmet Ali Nahit
authors.initials: MA
authors.lastname: Sendur
authors.forename: Dogan
authors.initials: D
authors.lastname: Yazilitas
authors.forename: Zuhat
authors.initials: Z
authors.lastname: Urakci
authors.forename: Ayse
authors.initials: A
authors.lastname: Durnali
authors.forename: Sinemis
authors.initials: S
authors.lastname: Yuksel
authors.forename: Sercan
authors.initials: S
authors.lastname: Aksoy
authors.forename: Dilsen
authors.initials: D
authors.lastname: Colak
authors.forename: Mehmet Metin
authors.initials: MM
authors.lastname: Seker
authors.forename: Burcu Yapar
authors.initials: BY
authors.lastname: Taskoylu
authors.forename: Arzu
authors.initials: A
authors.lastname: Oguz
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Isikdogan
authors.forename: Nurullah
authors.initials: N
authors.lastname: Zengin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D012306:Risk