title: [The effect of patterns of recurrence after radical resection of rectal cancer on long-term survival after recurrence].
abstract: OBJECTIVE
  To establish the classification of colorectal cancer recurrence patterns based on their relations to prognosis and recurrence.
  
  
  METHODS
  A total of 463 patients with recurrent rectal cancer (Stage I-III) following curative resection in our hospital from June 2002 to June 2012 were included consecutively. Recurrence status, time, location, survival time after relapse, curability, symptoms and CEA level were recorded. The correlation between each recurrent pattern and recurrent survival (RS) rate were analyzed retrospectively. The survival curve was drawn by Kaplan-Meier method. The Log-rank test was used to test the significance. Univariate analysis was performed by using Cox proportional hazard model.
  
  
  RESULTS
  Patients with recurrence within one year, multiple metastases, symptomatic disease, elevated CEA level and unresectable recurrence had significantly lower RS rate than patients with recurrence after one year, solitary metastasis, asymptomatic manifestation, normal CEA level and resectable recurrence respectively. The hazard ratio were 1.34 (95%CI 1.02-1.76, P= 0.033), 1.41 (95%CI 1.04-1.91, P= 0.026), 1.74 (95%CI 1.05-2.88, P= 0.032), 4.06 (95%CI 2.11-7.85, P<0.001) and 1.99 (95%CI 1.34-2.97, P= 0.001) respectively.
  
  
  CONCLUSIONS
  Early recurrence (<12 months), multiple metastases, symptomatic, unresectable recurrence and elevated CEA indicate poor prognosis after relapse. This study provides a systematic basis for the classification of recurrence in colorectal cancer after radical resection.
authors.affiliation: Department of Colon and Rectum Surgery, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510065, China.
authors.forename: Huichuan
authors.initials: H
authors.lastname: Yu
authors.forename: Yanxin
authors.initials: Y
authors.lastname: Luo
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Kang
authors.forename: Meijin
authors.initials: M
authors.lastname: Huang
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Deng
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Jianping
authors.initials: J
authors.lastname: Wang
mesh_terms: D006801:Humans; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate