title: Impact of anatomic location on locally recurrent rectal cancer: superior outcome for intraluminal tumour recurrence.
abstract: BACKGROUND
  Local recurrence of rectal cancer after curative surgery predicts patients' prognosis. The correlation between the exact anatomic location of tumour recurrence and patients' survival is still under debate. Thus, this study aimed to investigate the impact of the exact location of recurrent rectal cancer on post-operative morbidity and survival.
  
  
  METHODS
  This is a retrospective study including 90 patients with locally recurrent rectal cancer. The location of tumour recurrence was classified into intraluminal and extraluminal recurrence. Univariate and multivariable Cox regression analyses were used to determine the impact on post-operative morbidity and survival.
  
  
  RESULTS
  Patients' survival with intraluminal recurrence was significantly longer compared to patients with extraluminal recurrence (p = 0.027). Curative resection was associated with prolonged survival in univariate and multivariable analyses (p = 0.0001) and was more often achieved in patients with intraluminal recurrence (p = 0.024). Survival of curative resected patients with intraluminal recurrence was significantly longer compared to curatively resected patients with extraluminal recurrence (p = 0.0001). The rate of post-operative morbidity between intraluminal and extraluminal recurrence was not statistically different (p = 0.59).
  
  
  CONCLUSIONS
  Based on the present investigation, intraluminal recurrence is associated with superior outcome. Post-operative morbidity did not differ significantly between both groups.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Klose
authors.forename: Ignazio
authors.initials: I
authors.lastname: Tarantino
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmidt
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Yakup
authors.initials: Y
authors.lastname: Kulu
authors.forename: Tobias
authors.initials: T
authors.lastname: Wagner
authors.forename: Martin
authors.initials: M
authors.lastname: Schneider
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.forename: Alexis
authors.initials: A
authors.lastname: Ulrich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy; D012007:Rectum / Q000473:pathology*; D012189:Retrospective Studies
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