title: A multicenter experience with peri-rectal tumors: The risk of local recurrence.
abstract: Peri-rectal tumors are rare and their management is challenging, especially when presenting with local recurrence. The aim of the current study was to report a multicenter series of peri-rectal tumors, focusing on the risk of recurrence.
  
  
  
  From 1994 to 2014, patients with peri-rectal tumors from three different centers were retrospectively analyzed. Sixty-two patients were identified and divided into two groups; Group 1: patients who presented with local recurrence at follow-up (n = 9, recurrence rate: 14.5%), and Group 2: patients without recurrence (n = 53).
  
  
  
  In Group 1, there were initially more patients with symptoms of a perineal mass (44.4% vs. 12.2%; p = 0.04), more malignant tumors (55.6% vs. 15.1%; p = 0.02), and larger lesions (+2.6 cm; p = 0.004). Incomplete resection was also more frequent in Group 1 (44.4% vs. 3.8%; p = 0.003). Eight patients with recurrence had further surgery, whilst one patient had radiological recurrence and was treated medically. Among the eight re-resections, five patients remain disease-free; two have had further recurrences and have had palliative treatment, whilst another has had a further resection and remains disease-free.
  
  
  
  Peri-rectal tumors are uncommon and there is no consensus on best management. Based on this large multicenter series, several risk factors seem to be associated with local recurrence, namely patient- (discovery of a perineal mass), tumor- (malignant and large lesion), and surgery-related (incomplete resection). Clinical follow-up should be adapted according to these factors.
authors.affiliation: Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK; Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland. Electronic address: Nicolas.c.buchs@hcuge.ch.
authors.forename: N C
authors.initials: NC
authors.lastname: Buchs
authors.affiliation: Department of Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Gosselink
authors.affiliation: Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: C R
authors.initials: CR
authors.lastname: Scarpa
authors.affiliation: Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Ris
authors.affiliation: Department of Pathology, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Saiji
authors.affiliation: Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK.
authors.forename: A L A
authors.initials: AL
authors.lastname: Bloemendaal
authors.affiliation: Department of Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: R S
authors.initials: RS
authors.lastname: van Onkelen
authors.affiliation: Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Guy
authors.affiliation: Department of Surgery, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: W R
authors.initials: WR
authors.lastname: Schouten
authors.affiliation: Clinic for Visceral and Transplantation Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Roche
authors.affiliation: Department of Colorectal Surgery, Churchill Hospital, Oxford University Hospitals, Oxford, UK.
authors.forename: B D
authors.initials: BD
authors.lastname: George
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000517:prevention & control; D012004:Rectal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012306:Risk
keywords: Ischiorectal; Outcomes; Presacral; Recurrence; Retrorectal; Surgery; Tumors