Clinical Analysis of Surgical Treatment for Mid and Lower Rectal Cancers

ABSTRACT

PURPOSE: The aim of this retrospective study was to evaluate the risk of local recurrence such as patients who were treated for Dukes stage B and C low rectal cancer by abdominoperineal resection (APR) or low anterior resection (LAR). METHODS: From 1985 to 1995, 81 patients with low rectal cancers which were within 3~8 cm from the anal verge were treated by curative resection, 38 by APR and 43 by LAR. The present study examined clinical and tumor characteristics, type of intervention as potential predictors of local recurrence. Retrospective data were analysed by univariate Chi-square tests. RESULTS: Local recurrence was diagnosed in 17 of 81 patients with a median follow-up period of 24 months. The local recurrence rate was 23.6% (9 of 38) after APR and 18.6% (8 of 43) after LAR. There was no difference in local recurrence between patients who had APR and LAR (P=0.58). Also we could not find any significant differences among age (65 years, P=0.53), sex (M vs F, P=0.57), sized of tumors (5 cm, P=0.32), distance from anal verge (5 cm, P=0.57), Dukes stage (B vs C, P=0.22), histological grade (well and moderate vs poorly, P=0.17), distance from distal resection margin (2 cm, P=0.35). CONCLUSIONS: The tumor factors such as Dukes' stage were more critical for pelvic recurrences than other patient factors.