Incidence of Local Recurrence After Curative Operations for Cancer of the Rectum1

Abstract

CARCINOMA OF RECTUM CHAPUIS ET ALll 12 GEHAN EA Ageneralised Wilcoxon Test for comparing arbitarily 13 PENFOLD JCB A comparison of restorative resection o f , single-censored samples 61ornetnka 1965 52 203-223 carcinoma of the middle third of the rectum with 18 abdominoperineal excision AuST NZ J SURG 1974, 14 MAYO CW FLY OA Analysis of five year survival In carcinoma of the rectum and rectosigmoid Surg Gynecol Obstet 1956 103 94-1 00 anterior resection for carcinoma of the rectum and rectosigmoid Surg Gynecol Obstet 1958, 106 695-698 16 DEDDISH MR STEARNS MW Anterior resection for Carcinoma of 21 the rectum and rectosigmoid area Ann Surg 1961, 154961-966 44 354-356 l9 15 MAYO CW LABERGE MY HARDY WM Five year survival after 20 SLANETZ, CA. HERTER FP, GRINNELL RS, Anterior resection versus abdominoperineal resection for cancer of the rectum and rectosigmoid. Am J Surg .1972; 123:llO-117. GLEN F, MCSHERRY CK. Carcinoma of the distal large bowel: 32-year-review of 1,026 cases. Ann Surg 1966; 163:838-849. NICHOLLS RJ, RITCHIE JK, WADSWORTH J, PARKS AG. Total excision or restorative resection for carcinoma of the middle third of the rectum. 6 r J Surg 1979; 66:625-627. PATEL S . TOVEE EB, LANGER B. Twenty-five years of experience with radical surgical treatment of carcinoma of the extraperitoneal rectum. Surgery 1977; 82:460-465. WHITTAKER M, GOLIGHER JC. The prognosis after surgical treatment for carcinoma of the rectum. 6 r J Surg 1976; 63:384-388.

Local recurrence after curative excision of the rectum for cancer without adjuvant therapy: role of total anatomical dissection

“…Differences between rates may be due to case mix 2,3 , surgical expertise 3±5 , differences in de®nition of local recurrence (pelvic only versus pelvic recurrence in the presence of metastatic disease) 6±8 , incomplete reporting of histopathological ®ndings 9 , lack of clarity in the de®nition of a curative operation 10 , variability in the protocol for and length of follow-up 6,11 , variability in data collection 12 and variability in the way in which local recurrence rates are calculated 8,13 . Furthermore, there have been few convincing studies of patient and tumour characteristics that might reliably predict local recurrence 14,15 . Such a study would require a large prospective patient cohort treated by standardized surgery alone, followed over a period of time suf®ciently long for most local recurrences to occur, and would include a comprehensive range of clinical variables with standardized pathology and staging.…”

Locally recurrent rectal cancer: Role of composite resection of extensive pelvic tumors with strategies for minimizing risk of recurrence

“…The issue of the safety of sphincter-saving resections for low rectal cancer remains somewhat troublesome. The British Large Bowel Cancer Project [9] found a higher local recurrence rate (18%) after anterior resection, than after abdominoperineal resection (12%, P < 0.02), as did the National Surgical Adjuvant Breast and Bowel Project R-01 [19], whereas many other, smaller studies [5,13,15,20,21] have found no significant difference in local failure rates between the two procedures.…”

“…Without doubt, lymph node involvement and full thickness penetration of the muscular wall of the rectum are the most influential factors; thus risk increases significantly with advancing T or N stage [7][8][9][10][11][12][13][14]. While other pathologic features of the primary tumor have been implicated (including microvascular and perineural invasion [12], tumor grade, and morphology [15]), their importance is overshadowed by depth of invasion and nodal status.…”

Results of Extrafascial Excision and Conventional Surgery for Rectal Cancer at Auckland Hospital

“…Other studies have shown that local recurrence rates are related to Dukes' stage of the cancer, 9,[12][13][14][15] tumour grade, 12,[15][16][17] tumour distance from the anal verge, 12,15 inadequate distal 18 and circumferential margins, [19][20][21][22] and the use of adjuvant radiotherapy [23][24][25][26] as well as surgical technique. 13,27 Because this study is Fig.…”